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General NPI Number Information
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NPI Number | 1548471469
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Entity Type | Organization
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Legal Business Name | YOUR FAMILY CARE CENTER INC
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 06/03/2019
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Provider Practice Location Address
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Address Line | 16300 SAND CANYON AVE STE 602
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City | IRVINE
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State | CA
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Zip | 92618-3706
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Country | US
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Telephone | 949-783-1911
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Fax | 714-541-5755
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Provider Business Mailing Address
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Address Line | 801 N TUSTIN AVE STE 203
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City | SANTA ANA
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State | CA
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Zip | 92705-3600
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Country | US
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Telephone | 714-541-5355
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Fax | 714-541-5755
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHIDA SAAM
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Credential | DO
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Telephone | 714-541-5355
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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 | 20A6743
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License Number State | CA
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