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General NPI Number Information
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NPI Number | 1265253504
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Entity Type | Organization
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Legal Business Name | CENTERED MEDICINE, PC
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Dates
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Enumeration Date | 10/21/2024
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 7850 VISTA HILL AVE
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City | SAN DIEGO
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State | CA
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Zip | 92123-2717
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Country | US
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Telephone | 858-836-8434
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 270875
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City | SAN DIEGO
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State | CA
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Zip | 92198-2875
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Country | US
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Telephone | 858-375-6670
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Fax |
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Authorized Official
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Title or Position | BILLER
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Name | AGNES M LOONIE
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Credential |
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Telephone | 619-294-4119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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