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General NPI Number Information
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NPI Number | 1699157701
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Entity Type | Organization
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Legal Business Name | PROVIDENCE HEALTHCARE PARTNERS,, INC
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Dates
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Enumeration Date | 06/25/2015
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Last Update Date | 10/27/2023
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Provider Practice Location Address
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Address Line | 4445 MAGNOLIA AVE
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City | RIVERSIDE
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State | CA
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Zip | 92501-4135
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Country | US
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Telephone | 714-676-3880
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Fax |
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Provider Business Mailing Address
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Address Line | 12223 HIGHLAND AVE SUITE 106-526
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91739-2574
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Country | US
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Telephone | 951-775-2407
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. CALVIN PATEL
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Credential | M.D.
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Telephone | 909-241-2195
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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 |
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License Number State |
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