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General NPI Number Information
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NPI Number | 1306978945
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Entity Type | Organization
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Legal Business Name | PORT CITY OPERATING COMPANY, LLC
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 509 W WEBER AVE STE 200
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City | STOCKTON
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State | CA
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Zip | 95203-3107
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Country | US
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Telephone | 858-275-8112
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Fax | 779-803-8118
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Provider Business Mailing Address
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Address Line | PO BOX 213008
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City | STOCKTON
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State | CA
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Zip | 95213-9008
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Country | US
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Telephone | 858-275-8112
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Fax | 779-803-8118
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Authorized Official
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Title or Position | SYSTEM CHIEF FINANCIAL OFFICER
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Name | DANIEL MORISETTE
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Credential |
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Telephone | 858-275-8112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 100000166
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License Number State | CA
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