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General NPI Number Information
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NPI Number | 1306367024
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Entity Type | Organization
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Legal Business Name | TRUSTED CARE INLAND VALLEY CA, LLC
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Dates
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Enumeration Date | 07/03/2017
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 2720 N GAREY AVE
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City | POMONA
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State | CA
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Zip | 91767
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Country | US
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Telephone | 602-715-1654
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Fax |
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Provider Business Mailing Address
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Address Line | 2720 N GAREY AVE
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City | POMONA
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State | CA
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Zip | 91767-1810
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Country | US
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Telephone | 602-715-1654
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | WAYNE DESTEFANO
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Credential |
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Telephone | 602-715-1654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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