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General NPI Number Information
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NPI Number | 1588338164
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Entity Type | Organization
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Legal Business Name | SOUTH BAY MEDICAL SERVICES CORPORATION
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Dates
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Enumeration Date | 08/05/2021
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Last Update Date | 08/05/2021
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Provider Practice Location Address
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Address Line | 3720 LOMITA BLVD
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City | TORRANCE
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State | CA
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Zip | 90505-3884
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Country | US
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Telephone | 310-802-6260
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Fax |
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Provider Business Mailing Address
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Address Line | 4141 W 162ND ST
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City | LAWNDALE
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State | CA
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Zip | 90260-2704
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Country | US
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Telephone | 310-989-3389
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. ZACHARY URIARTE
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Credential | R.T.(R)(ARRT)
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Telephone | 310-989-3389
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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License Number |
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License Number State |
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