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General NPI Number Information
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NPI Number | 1295989226
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Entity Type | Organization
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Legal Business Name | HIGH DESERT MEDICAL OFFICE
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Dates
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Enumeration Date | 11/04/2008
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Last Update Date | 06/18/2019
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Provider Practice Location Address
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Address Line | 14298 ST. ANDREWS DR SUITE 11
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City | VICTORVILLE
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State | CA
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Zip | 92395
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Country | US
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Telephone | 760-243-2311
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Fax | 760-243-2880
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Provider Business Mailing Address
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Address Line | 14298 ST. ANDREWS DR SUITE 11
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City | VICTORVILLE
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State | CA
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Zip | 92395
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Country | US
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Telephone | 760-243-2311
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Fax | 760-243-2880
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ANGELA L. ZIPSER
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Credential |
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Telephone | 760-243-2311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NI0900X
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Taxonomy Name | Internist Chiropractor
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License Number | 14177
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 111NI0900X
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Taxonomy Name | Internist Chiropractor
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License Number | G43728
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License Number State | CA
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