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General NPI Number Information
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NPI Number | 1275716722
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Entity Type | Organization
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Legal Business Name | RAFAEL E. CUELLAR, MD, INC.
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Dates
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Enumeration Date | 12/06/2007
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Last Update Date | 12/16/2010
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Provider Practice Location Address
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Address Line | 2341 S MELROSE DR
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City | VISTA
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State | CA
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Zip | 92081-8788
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Country | US
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Telephone | 760-599-1222
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Fax | 760-599-1221
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Provider Business Mailing Address
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Address Line | 2341 S MELROSE DR
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City | VISTA
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State | CA
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Zip | 92081-8788
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Country | US
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Telephone | 760-599-1222
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Fax | 760-599-1221
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAFAEL E CUELLAR
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Credential | M.D.
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Telephone | 760-599-1222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | A42213
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License Number State | CA
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