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General NPI Number Information
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NPI Number | 1578199147
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Entity Type | Organization
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Legal Business Name | PINNACLE PAIN & REGENERATIVE MEDICINE INC
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Dates
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Enumeration Date | 03/16/2020
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Last Update Date | 03/16/2020
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Provider Practice Location Address
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Address Line | 24452 HEALTH CENTER DR
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-3604
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Country | US
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Telephone | 949-290-3972
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Fax | 562-786-8613
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Provider Business Mailing Address
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Address Line | 26051 RED CORRAL RD
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-6310
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Country | US
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Telephone | 949-290-3972
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Fax | 562-786-8613
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | PAOLO JORGE
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Credential | MD
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Telephone | 949-290-3972
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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