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General NPI Number Information
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NPI Number | 1346540150
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Entity Type | Organization
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Legal Business Name | BEARSHORNS LLC
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Dates
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Enumeration Date | 10/26/2010
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Last Update Date | 10/26/2010
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Provider Practice Location Address
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Address Line | 52 CUPERTINO CIR
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City | ALISO VIEJO
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State | CA
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Zip | 92656-8076
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Country | US
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Telephone | 949-215-2150
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Fax |
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Provider Business Mailing Address
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Address Line | 26060 ACERO SUITE 101
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City | MISSION VIEJO
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State | CA
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Zip | 92691-2768
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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 | MANAGER
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Name | MR. EDWIN C CRUZ
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Credential |
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Telephone | 949-215-2150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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