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General NPI Number Information
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NPI Number | 1568447878
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Entity Type | Individual
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Provider Name | SALLY J DENARDO M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/08/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4501 X ST SUITE 3016
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City | SACRAMENTO
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State | CA
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Zip | 95817-2229
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Country | US
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Telephone | 916-734-3787
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Fax | 916-451-2857
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Provider Business Mailing Address
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Address Line | 44336 CLUBHOUSE DR
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City | DAVIS
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State | CA
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Zip | 95618-1019
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Country | US
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Telephone | 916-734-3787
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G12877
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License Number State | CA
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