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General NPI Number Information
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NPI Number | 1508075482
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Entity Type | Organization
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Legal Business Name | RECTO F. DELEON, M.D. INC.
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1130 COFFEE RD STE 9B
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City | MODESTO
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State | CA
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Zip | 95355-4228
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Country | US
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Telephone | 209-527-7677
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Fax | 209-527-2306
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Provider Business Mailing Address
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Address Line | 1130 COFFEE RD STE 9B
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City | MODESTO
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State | CA
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Zip | 95355-4228
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Country | US
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Telephone | 209-527-7677
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Fax | 209-527-2306
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. RECTO FERNANDEZ DELEON
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Credential | M.D.
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Telephone | 209-527-7677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A24912
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License Number State | CA
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