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General NPI Number Information
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NPI Number | 1467717702
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Entity Type | Organization
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Legal Business Name | EL CAMINO AMBULATORY SURGERY CENTER LLC
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Dates
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Enumeration Date | 07/12/2012
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Last Update Date | 07/12/2012
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Provider Practice Location Address
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Address Line | 2480 GRANT RD
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-4333
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Country | US
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Telephone | 650-961-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 375 FOREST AVE
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City | PALO ALTO
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State | CA
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Zip | 94301-2521
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CAROLE WILSON
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Credential |
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Telephone | 650-289-1655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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