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General NPI Number Information
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NPI Number | 1528508827
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Entity Type | Organization
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Legal Business Name | MANUEL SACPANO MD INC
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Dates
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Enumeration Date | 03/06/2017
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Last Update Date | 03/06/2017
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Provider Practice Location Address
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Address Line | 13222 BLOOMFIED AVE
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City | NORWALK
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State | CA
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Zip | 90650-3249
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Country | US
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Telephone | 714-522-2001
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Fax | 714-522-7503
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Provider Business Mailing Address
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Address Line | 7439 LA PALMA AVE PMB 120
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City | BUENA PARK
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State | CA
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Zip | 90620-2655
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Country | US
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Telephone | 714-522-2001
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Fax | 714-522-7503
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Authorized Official
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Title or Position | OWNER
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Name | DR. MANUEL SACAPANO
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Credential | M.D.
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Telephone | 714-522-2001
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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 | A77588
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License Number State | CA
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