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General NPI Number Information
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NPI Number | 1477262137
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Entity Type | Organization
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Legal Business Name | DESERT CARE MEDICAL CLINIC
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Dates
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Enumeration Date | 11/21/2022
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Last Update Date | 11/21/2022
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Provider Practice Location Address
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Address Line | 81557 DOCTOR CARREON BLVD STE B2&B3
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City | INDIO
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State | CA
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Zip | 92201-5517
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Country | US
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Telephone | 442-400-3435
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Fax |
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Provider Business Mailing Address
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Address Line | 81557 DOCTOR CARREON BLVD STE B2&B3
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City | INDIO
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State | CA
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Zip | 92201-5517
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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 | OWNER
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Name | RICHARD HEIMANN
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Credential |
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Telephone | 442-400-3435
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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