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General NPI Number Information
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NPI Number | 1346788064
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Entity Type | Organization
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Legal Business Name | CALIFORNIA VASCULAR CENTER, INC.
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Dates
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Enumeration Date | 02/01/2017
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Last Update Date | 02/01/2017
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Provider Practice Location Address
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Address Line | 1335 CYPRESS ST STE 207
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City | SAN DIMAS
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State | CA
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Zip | 91773-3539
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Country | US
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Telephone | 909-542-2900
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Fax | 909-592-6000
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Provider Business Mailing Address
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Address Line | 255 E BONITA AVE BUILDING -1, 2ND FLOOR
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City | POMONA
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State | CA
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Zip | 91767-1923
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Country | US
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Telephone | 909-542-2900
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Fax | 909-592-6000
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. ABID A RIZVI
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Credential | M.D.
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Telephone | 909-542-2900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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