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General NPI Number Information
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NPI Number | 1255738613
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Entity Type | Organization
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Legal Business Name | DR RACHEL MAYORGA MD PC
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Dates
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Enumeration Date | 12/01/2014
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Last Update Date | 11/10/2021
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Provider Practice Location Address
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Address Line | 421 MARCH AVE STE D
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City | HEALDSBURG
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State | CA
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Zip | 95448-3367
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Country | US
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Telephone | 707-385-0222
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Fax | 707-629-4849
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Provider Business Mailing Address
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Address Line | 421 MARCH AVE STE D
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City | HEALDSBURG
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State | CA
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Zip | 95448-3367
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Country | US
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Telephone | 707-385-0222
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RACHEL MAYORGA
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Credential | MD
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Telephone | 707-755-0095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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