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General NPI Number Information
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NPI Number | 1295114965
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Entity Type | Organization
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Legal Business Name | ADVANCED CARE MEDICAL GROUP INC
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Dates
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Enumeration Date | 05/27/2015
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Last Update Date | 06/22/2025
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Provider Practice Location Address
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Address Line | 3130 W CALDWELL AVE
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City | VISALIA
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State | CA
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Zip | 93277-7063
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Country | US
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Telephone | 559-635-7800
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7475
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City | VISALIA
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State | CA
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Zip | 93290-7475
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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 | OWNER
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Name | SHAWN CARDOZA
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Credential | N.P.
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Telephone | 559-635-7800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G72459
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License Number State | CA
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