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General NPI Number Information
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NPI Number | 1710039573
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Entity Type | Organization
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Legal Business Name | HARBOR MEDICAL GROUP INC
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 03/23/2011
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Provider Practice Location Address
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Address Line | 1661 SOQUEL DR BUILDING A
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City | SANTA CRUZ
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State | CA
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Zip | 95065-1709
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Country | US
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Telephone | 831-476-7676
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Fax |
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Provider Business Mailing Address
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Address Line | 1661 SOQUEL DR BLDG A
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City | SANTA CRUZ
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State | CA
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Zip | 95065-1709
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Country | US
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Telephone | 831-476-7676
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Fax | 831-476-4824
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. TAMI L PIUMARTA
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Credential |
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Telephone | 831-476-7676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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