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General NPI Number Information
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NPI Number | 1699674242
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Entity Type | Organization
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Legal Business Name | INTEGRATED COMPLEX CARE ASSOCIATES
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Dates
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Enumeration Date | 11/02/2026
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Last Update Date | 11/02/2026
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Provider Practice Location Address
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Address Line | 1555 EAST ST STE 300B
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City | REDDING
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State | CA
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Zip | 96001-1160
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Country | US
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Telephone | 530-242-4683
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Fax |
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Provider Business Mailing Address
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Address Line | 1555 EAST ST STE 300B
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City | REDDING
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State | CA
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Zip | 96001-1160
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Country | US
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Telephone | 530-242-4683
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Fax |
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Authorized Official
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Title or Position | ACCESS MANAGER
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Name | JACOB HALPERT
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Credential |
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Telephone | 607-738-6356
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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