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General NPI Number Information
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NPI Number | 1639570971
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Entity Type | Organization
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Legal Business Name | GRACE HOSPITALIST GROUP, INC.
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Dates
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Enumeration Date | 09/05/2014
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Last Update Date | 06/29/2023
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Provider Practice Location Address
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Address Line | 36485 INLAND VALLEY DR
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City | WILDOMAR
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State | CA
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Zip | 92595-9681
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Country | US
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Telephone | 951-767-1392
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Fax | 888-479-9933
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Provider Business Mailing Address
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Address Line | 36322 BLADEN AVE
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City | MURRIETA
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State | CA
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Zip | 92562-6501
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Country | US
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Telephone | 909-731-0387
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Fax | 888-479-9933
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAMI ELMUFDI
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Credential | M.D.
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Telephone | 909-731-0387
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | A108497
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License Number State | CA
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