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NPI 1578756409

NPI 1578756409 : ALEXANDER CARLI, M.D., F.A.C.S., INC. : RIVERSIDE, CA

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General NPI Number Information
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    NPI Number           |    1578756409
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    Entity Type          |    Organization 
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    Legal Business Name  |    ALEXANDER CARLI, M.D., F.A.C.S., INC. 
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Dates
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    Enumeration Date     |    08/23/2007
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    Last Update Date     |    09/23/2008
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Provider Practice Location Address
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    Address Line         |    10694 MAGNOLIA AVE 
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    City                 |    RIVERSIDE
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    State                |    CA
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    Zip                  |    92505-1816
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    Country              |    US
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    Telephone            |    951-688-8660
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    Fax                  |    951-688-2803
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Provider Business Mailing Address
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    Address Line         |    10694 MAGNOLIA AVE 
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    City                 |    RIVERSIDE
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    State                |    CA
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    Zip                  |    92505-1816
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    Country              |    US
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    Telephone            |    951-688-8660
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    Fax                  |    951-688-2803
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Authorized Official
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    Title or Position    |    OWNER/PRESIDENT
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    Name                 |    DR. ALEXANDER  CARLI 
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    Credential           |    M.D., F.A.C.S.
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    Telephone            |    951-688-8660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    174400000X
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    Taxonomy Name        |    Specialist
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    License Number       |    A37286
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    License Number State |    CA
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