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General NPI Number Information
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NPI Number | 1629200613
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Entity Type | Organization
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Legal Business Name | CALIFORNIA MEDICAL FACILITY
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Dates
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Enumeration Date | 08/10/2009
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Last Update Date | 08/10/2009
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Provider Practice Location Address
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Address Line | 1600 CALIFORNIA DR 1600 CALIFORNIA DR.
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City | VACAVILLE
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State | CA
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Zip | 95687
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Country | US
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Telephone | 707-449-6560
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Fax | 707-453-7039
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Provider Business Mailing Address
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Address Line | 1600 CALIFORNIA DR
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City | VACAVILLE
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State | CA
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Zip | 95687
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Country | US
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Telephone | 707-449-6560
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Fax | 707-453-7039
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | MS. LINDA D. GARCIA
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Credential |
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Telephone | 707-449-6560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number | G52029
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License Number State | CA
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