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General NPI Number Information
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NPI Number | 1386080240
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Entity Type | Organization
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Legal Business Name | STEPHEN SIMS MD
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Dates
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Enumeration Date | 05/20/2013
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Last Update Date | 05/20/2013
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Provider Practice Location Address
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Address Line | 877 W FREMONT AVE SUITE B2
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City | SUNNYVALE
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State | CA
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Zip | 94087-2315
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Country | US
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Telephone | 408-736-0677
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Fax |
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Provider Business Mailing Address
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Address Line | 877 W FREMONT AVE SUITE B2
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City | SUNNYVALE
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State | CA
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Zip | 94087-2315
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Country | US
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Telephone | 408-736-0677
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEPHEN JUSTIN SIMS
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Credential | M.D.
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Telephone | 408-736-0677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | G69269
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License Number State | CA
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