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General NPI Number Information
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NPI Number | 1609260223
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Entity Type | Organization
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Legal Business Name | C&M VICTORIA LANE INC.
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Dates
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Enumeration Date | 03/20/2015
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Last Update Date | 03/20/2015
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Provider Practice Location Address
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Address Line | 1801 BATH ST
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City | SANTA BARBARA
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State | CA
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Zip | 93101-2810
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Country | US
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Telephone | 805-569-3701
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Fax | 805-569-7070
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Provider Business Mailing Address
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Address Line | 225 N LOMITA AVE
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City | OJAI
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State | CA
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Zip | 93023-1541
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Country | US
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Telephone | 805-646-2402
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ARTHUR MEDEL
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Credential |
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Telephone | 703-945-9137
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 425801552
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License Number State | CA
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