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General NPI Number Information
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NPI Number | 1558699686
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Entity Type | Organization
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Legal Business Name | ADVANCED PRACTICE SERVICES
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Dates
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Enumeration Date | 12/01/2009
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Last Update Date | 12/01/2009
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Provider Practice Location Address
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Address Line | 20377 SW ACACIA ST.
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City | NEWPORT BEACH
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State | CA
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Zip | 92660
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Country | US
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Telephone | 949-777-3100
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Fax | 949-777-3177
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Provider Business Mailing Address
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Address Line | 20377 SW ACACIA ST
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City | NEWPORT BEACH
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State | CA
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Zip | 92660
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Country | US
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Telephone | 949-777-3100
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Fax | 949-777-3177
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. MATTHEW LEE UMBS
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Credential |
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Telephone | 949-777-3334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number | BT30023362
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License Number State | CA
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