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General NPI Number Information
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NPI Number | 1609953470
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Entity Type | Organization
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Legal Business Name | ANAHEIM HEALTH CARE CENTER
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 1125 N MAGNOLIA AVE STE 115
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City | ANAHEIM
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State | CA
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Zip | 92801-2689
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Country | US
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Telephone | 714-484-1280
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Fax |
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Provider Business Mailing Address
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Address Line | 2101 WILD CANYON DR
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City | COLTON
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State | CA
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Zip | 92324-9521
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Country | US
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Telephone | 909-433-0232
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Fax |
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Authorized Official
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Title or Position | PA
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Name | FLORICA POTRA-CIONCA
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Credential | PA-C
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Telephone | 714-484-1280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA18687
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License Number State | CA
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