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General NPI Number Information
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NPI Number | 1356695266
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Entity Type | Organization
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Legal Business Name | ALTAMED HEALTH SERVICES CORPORATION
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Dates
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Enumeration Date | 10/30/2012
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Last Update Date | 10/30/2012
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Provider Practice Location Address
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Address Line | 1300 S SUNSET AVE
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City | WEST COVINA
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State | CA
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Zip | 91790-3342
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Country | US
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Telephone | 626-214-7454
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Fax | 626-337-1430
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Provider Business Mailing Address
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Address Line | 1300 S SUNSET AVE
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City | WEST COVINA
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State | CA
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Zip | 91790-3342
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Country | US
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Telephone | 626-214-7454
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Fax | 626-337-1430
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Authorized Official
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Title or Position | HEALTH EDUCATION MANAGER
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Name | MRS. JESSICA SOLARES
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Credential |
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Telephone | 323-552-7651
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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