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General NPI Number Information
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NPI Number | 1639046568
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Entity Type | Individual
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Provider Name | AMANDA BLINKINSOP PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/23/2025
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 17577 ARROW BLVD
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City | FONTANA
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State | CA
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Zip | 92335-4011
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Country | US
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Telephone | 909-823-4454
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Fax |
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Provider Business Mailing Address
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Address Line | 1855 W REDLANDS BLVD FL 2
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City | REDLANDS
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State | CA
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Zip | 92373-3145
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Country | US
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Telephone | 909-890-0407
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 67214
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License Number State | CA
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