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General NPI Number Information
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NPI Number | 1477047355
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Entity Type | Organization
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Legal Business Name | ALLEGIANT HEALTHCARE, INC
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Dates
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Enumeration Date | 06/14/2018
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Last Update Date | 06/14/2018
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Provider Practice Location Address
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Address Line | 363 S PARK AVE STE 101
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City | POMONA
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State | CA
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Zip | 91766-1560
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Country | US
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Telephone | 909-323-4023
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Fax |
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Provider Business Mailing Address
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Address Line | 1070 ALYESKA PL
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City | WALNUT
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State | CA
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Zip | 91789-4320
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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/CLINICAL MANAGER
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Name | DANIEL HURTADO
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Credential |
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Telephone | 323-547-1996
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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