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General NPI Number Information
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NPI Number | 1639983471
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Entity Type | Organization
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Legal Business Name | PUREBREATHE RESPIRATORY CARE
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Dates
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Enumeration Date | 02/03/2025
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 27125 SIERRA HWY STE 325 2ND FLOOR
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City | SANTA CLARITA
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State | CA
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Zip | 91351
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Country | US
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Telephone | 702-955-6376
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Fax |
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Provider Business Mailing Address
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Address Line | 8605 SANTA MONICA BLVD PMB 448053
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90069
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Country | US
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Telephone | 702-955-6376
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | JR JESS MATA
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Credential |
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Telephone | 702-955-6376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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