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General NPI Number Information
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NPI Number | 1568437440
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Entity Type | Organization
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Legal Business Name | AMDC
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Dates
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Enumeration Date | 02/22/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 4870 BARRANCA PKWY SUITE 110
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City | IRVINE
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State | CA
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Zip | 92604-4709
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Country | US
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Telephone | 949-857-1248
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Fax | 949-559-1165
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Provider Business Mailing Address
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Address Line | PO BOX 3699
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City | NEWPORT BEACH
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State | CA
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Zip | 92659-8699
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Country | US
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Telephone | 949-857-1248
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Fax | 949-559-1165
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. MICHAEL FRAZE
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Credential | M.D.
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Telephone | 310-510-0700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | A69508
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 282NR1301X
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Taxonomy Name | Rural Acute Care Hospital
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License Number | A69508
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A69508
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License Number State | CA
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