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General NPI Number Information
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NPI Number | 1629695432
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Entity Type | Organization
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Legal Business Name | PHLEBOTOMY DIRECT, LLC
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Dates
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Enumeration Date | 06/26/2020
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Last Update Date | 06/26/2020
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Provider Practice Location Address
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Address Line | 401 E BISHOP ST
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City | SANTA ANA
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State | CA
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Zip | 92701-5937
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Country | US
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Telephone | 562-972-4628
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8366
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92728-8366
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/COO
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Name | VELIA REGALADO
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Credential |
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Telephone | 714-497-0497
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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