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General NPI Number Information
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NPI Number | 1427469485
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Entity Type | Organization
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Legal Business Name | SHIRLEY R. VILLARICA, M.D. INC.
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Dates
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Enumeration Date | 05/13/2014
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Last Update Date | 05/13/2014
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Provider Practice Location Address
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Address Line | 1135 S SUNSET AVE STE 410
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City | WEST COVINA
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State | CA
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Zip | 91790-3965
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Country | US
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Telephone | 626-814-8800
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Fax | 626-814-8811
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Provider Business Mailing Address
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Address Line | 1135 S SUNSET AVE STE 410
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City | WEST COVINA
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State | CA
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Zip | 91790-3965
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Country | US
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Telephone | 626-814-8800
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Fax | 626-814-8811
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHIRLEY VILLARICA
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Credential | M.D.
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Telephone | 626-814-8800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | A32139
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License Number State | CA
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