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General NPI Number Information
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NPI Number | 1366546970
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Entity Type | Organization
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Legal Business Name | PETER CHIRICO
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 12/23/2008
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Provider Practice Location Address
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Address Line | 3901 LAS POSAS RD SUITE #7
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City | CAMARILLO
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State | CA
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Zip | 93010-1502
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Country | US
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Telephone | 805-987-6851
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Fax | 805-987-8045
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Provider Business Mailing Address
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Address Line | 3901 LAS POSAS RD SUITE #7
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City | CAMARILLO
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State | CA
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Zip | 93010-1502
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Country | US
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Telephone | 805-987-6851
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Fax | 805-987-8045
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Authorized Official
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Title or Position | OWNER ADMINISTRATOR
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Name | MR. PETER CHIRICO
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Credential | PT
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Telephone | 805-987-6851
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT8303
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License Number State | CA
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