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NPI 1598426504

NPI 1598426504 : MARLENE M CORDERO M.D INCORPORATED. : TEMPLETON, CA

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General NPI Number Information
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    NPI Number           |    1598426504
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    Entity Type          |    Organization 
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    Legal Business Name  |    MARLENE M CORDERO M.D INCORPORATED. 
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Dates
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    Enumeration Date     |    01/03/2022
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    Last Update Date     |    01/03/2022
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Provider Practice Location Address
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    Address Line         |    350 POSADA LN STE 203 
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    City                 |    TEMPLETON
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    State                |    CA
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    Zip                  |    93465-4060
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    Country              |    US
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    Telephone            |    805-434-5013
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    350 POSADA LN STE 203 
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    City                 |    TEMPLETON
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    State                |    CA
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    Zip                  |    93465-4060
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    Country              |    US
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    Telephone            |    180-543-4501
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    Fax                  |    
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |     MARLENE M CORDERO 
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    Credential           |    MD
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    Telephone            |    805-703-3353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QM0801X
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    Taxonomy Name        |    Mental Health Clinic/Center (Including Community Mental Health Center)
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    License Number       |    
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    License Number State |    
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