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General NPI Number Information
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NPI Number | 1578759114
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Entity Type | Organization
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Legal Business Name | HUGO G. ALTAMIRANO MD LLC
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Dates
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Enumeration Date | 09/18/2007
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Last Update Date | 01/24/2011
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Provider Practice Location Address
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Address Line | 745 N 500 W # 200
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City | PROVO
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State | UT
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Zip | 84601-1472
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Country | US
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Telephone | 801-375-9292
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Fax | 801-375-9290
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Provider Business Mailing Address
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Address Line | 745 N 500 W # 200
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City | PROVO
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State | UT
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Zip | 84601-1472
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Country | US
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Telephone | 801-375-9292
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Fax | 801-375-9290
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Authorized Official
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Title or Position | ASSOCIATE PHYSICIAN
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Name | DR. HUGO G ALTAMIRANO
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Credential | M.D.
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Telephone | 801-375-9292
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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 |
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License Number State |
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