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General NPI Number Information
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NPI Number | 1477848869
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Entity Type | Organization
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Legal Business Name | AMERICAN PARAMED
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Dates
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Enumeration Date | 06/14/2011
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Last Update Date | 06/14/2011
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Provider Practice Location Address
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Address Line | 3817 RUFFED GROUSE LN
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City | MODESTO
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State | CA
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Zip | 95355-8506
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Country | US
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Telephone | 209-846-4270
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Fax | 209-551-1253
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Provider Business Mailing Address
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Address Line | 3817 RUFFED GROUSE LN
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City | MODESTO
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State | CA
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Zip | 95355-8506
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Country | US
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Telephone | 209-846-4270
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Fax | 209-551-1253
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Authorized Official
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Title or Position | OWNER/PARAMEDICAL EXAMINER/PHLEBO
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Name | MRS. NICHOLE ANN ENRIQUEZ
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Credential | CPT-1
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Telephone | 209-846-4270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number | CPT00017343
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License Number State | CA
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