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General NPI Number Information
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NPI Number | 1497001226
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Entity Type | Organization
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Legal Business Name | VIA CARE COMMUNITY HEALTH CENTER
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Dates
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Enumeration Date | 07/30/2012
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Last Update Date | 02/22/2022
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Provider Practice Location Address
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Address Line | 507 S ATLANTIC BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90022-2621
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Country | US
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Telephone | 323-268-9191
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Fax | 323-268-9119
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Provider Business Mailing Address
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Address Line | 507 S ATLANTIC BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90022-2621
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Country | US
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Telephone | 323-268-9191
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Fax | 323-268-9119
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Authorized Official
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Title or Position | DIRECTOR OF HR
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Name | NINA FALCETTI
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Credential |
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Telephone | 323-268-9191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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