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NPI 1649743345

NPI 1649743345 : OSITA HEALTH CLINIC : OAKLAND, CA

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General NPI Number Information
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    NPI Number           |    1649743345
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    Entity Type          |    Organization 
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    Legal Business Name  |    OSITA HEALTH CLINIC 
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Dates
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    Enumeration Date     |    01/04/2019
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    Last Update Date     |    08/26/2019
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Provider Practice Location Address
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    Address Line         |    2521 SEMINARY AVE STE 1 
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    City                 |    OAKLAND
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    State                |    CA
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    Zip                  |    94605-1307
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    Country              |    US
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    Telephone            |    510-777-1000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2521 SEMINARY AVE 
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    City                 |    OAKLAND
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    State                |    CA
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    Zip                  |    94605-1307
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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    |    NURSE PRACTITIONER
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    Name                 |     CHRISTIANA  UMEH 
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    Credential           |    
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    Telephone            |    510-777-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261Q00000X
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    Taxonomy Name        |    Clinic/Center
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    License Number       |    
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    License Number State |    
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