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General NPI Number Information
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NPI Number | 1285615955
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Entity Type | Organization
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Legal Business Name | ROLAND D REINHART M D A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 11/09/2005
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Last Update Date | 10/24/2023
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Provider Practice Location Address
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Address Line | 39800 PORTOLA AVE
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City | PALM DESERT
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State | CA
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Zip | 92260-0620
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Country | US
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Telephone | 760-341-2360
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Fax | 760-346-5940
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Provider Business Mailing Address
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Address Line | PO BOX 14170
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City | PALM DESERT
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State | CA
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Zip | 92255-4170
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Country | US
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Telephone | 760-341-2360
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Fax | 760-346-5940
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ANDREA BOLANOS
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Credential |
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Telephone | 760-341-2360
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | A49097
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License Number State | CA
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