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General NPI Number Information
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NPI Number | 1669006490
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Entity Type | Organization
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Legal Business Name | PV HEALTHCARE CORP
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Dates
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Enumeration Date | 03/02/2020
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Last Update Date | 03/02/2020
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Provider Practice Location Address
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Address Line | 28212 KELLY JOHNSON PKWY STE 120
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City | VALENCIA
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State | CA
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Zip | 91355-5085
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Country | US
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Telephone | 661-282-1919
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Fax |
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Provider Business Mailing Address
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Address Line | 23817 GARLAND CT
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City | VALENCIA
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State | CA
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Zip | 91354-2603
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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
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Name | CAMELLIA BABAIE
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Credential | MD
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Telephone | 904-429-4188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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