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General NPI Number Information
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NPI Number | 1700810892
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Entity Type | Individual
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Provider Name | CALVIN SO
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Gender | Male
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | #32B, 2ND FL, BUILDING 'C', 1620 N. CARPENTER RD,
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City | MODESTO
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State | CA
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Zip | 95351
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Country | US
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Telephone | 209-324-7832
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Fax | 209-578-0308
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Provider Business Mailing Address
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Address Line | 2409 QUAIL MEADOW CT
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City | MODESTO
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State | CA
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Zip | 95355-9246
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Country | US
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Telephone | 209-578-0308
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Fax | 209-578-0308
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC10307
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License Number State | CA
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