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General NPI Number Information
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NPI Number | 1326525650
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Entity Type | Organization
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Legal Business Name | MERCED WOMENS CENTER FOR ADVANCED PELVIC SURGERY
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Dates
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Enumeration Date | 07/19/2018
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Last Update Date | 07/23/2018
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Provider Practice Location Address
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Address Line | 900 W OLIVE AVE STE A
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City | MERCED
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State | CA
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Zip | 95348
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Country | US
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Telephone | 209-579-5628
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Fax |
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Provider Business Mailing Address
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Address Line | 220 STANDIFORD AVE STE F
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City | MODESTO
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State | CA
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Zip | 95350-1159
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Country | US
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Telephone | 209-579-5628
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DIANE THOMAS
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Credential | MD
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Telephone | 415-286-1616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number |
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License Number State |
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