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General NPI Number Information
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NPI Number | 1255662607
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Entity Type | Organization
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Legal Business Name | DIVERSIFIED MEDICAL CENTER A
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Dates
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Enumeration Date | 01/25/2010
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Last Update Date | 05/11/2011
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Provider Practice Location Address
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Address Line | 1642 HOLMES ST
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City | LIVERMORE
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State | CA
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Zip | 94550-6010
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Country | US
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Telephone | 925-443-2062
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Fax |
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Provider Business Mailing Address
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Address Line | 1642 HOLMES ST
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City | LIVERMORE
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State | CA
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Zip | 94550-6010
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | DR. DEAN F WEINBERG
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Credential | D.C.
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Telephone | 925-443-2062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 28920
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | G8588
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License Number State | CA
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