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General NPI Number Information
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NPI Number | 1265971949
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Entity Type | Organization
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Legal Business Name | CALIFORNIA POST-ACUTE MEDICAL GROUP 1, INC.
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Dates
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Enumeration Date | 02/15/2017
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Last Update Date | 06/23/2017
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Provider Practice Location Address
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Address Line | 508 WESTLINE DR
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City | ALAMEDA
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State | CA
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Zip | 94501-5847
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Country | US
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Telephone | 702-233-0684
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Fax |
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Provider Business Mailing Address
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Address Line | 5000 HOPYARD RD SUITE 100
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City | PLEASANTON
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State | CA
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Zip | 94588-3348
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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 | PRESIDENT
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Name | MR. SUJAL MANDAVIA
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Credential | M.D
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Telephone | 865-693-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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