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General NPI Number Information
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NPI Number | 1699403253
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Entity Type | Individual
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Provider Name | ZACHARY ANDREW CRUZ OD
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Gender | Male
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Dates
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Enumeration Date | 08/11/2022
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Last Update Date | 08/12/2022
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Provider Practice Location Address
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Address Line | 29115 VALLEY CENTER RD STE E
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City | VALLEY CENTER
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State | CA
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Zip | 92082-6553
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Country | US
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Telephone | 760-751-8771
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Fax |
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Provider Business Mailing Address
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Address Line | 18725 CAMINITO CANTILENA APT 102
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City | SAN DIEGO
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State | CA
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Zip | 92128-6149
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Country | US
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Telephone | 209-352-4723
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 35157
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License Number State | CA
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