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General NPI Number Information
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NPI Number | 1710648928
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Entity Type | Organization
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Legal Business Name | OMEGA HEALTH CLINICS
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Dates
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Enumeration Date | 01/10/2022
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Last Update Date | 03/19/2024
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Provider Practice Location Address
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Address Line | 2909 COFFEE RD STE 12B
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City | MODESTO
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State | CA
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Zip | 95355-1751
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Country | US
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Telephone | 209-554-4181
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 576810
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City | MODESTO
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State | CA
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Zip | 95357-6810
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Country | US
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Telephone | 209-252-6676
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | NANDEESH VEERAPPA
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Credential |
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Telephone | 209-554-4181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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