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General NPI Number Information
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NPI Number | 1720727225
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Entity Type | Individual
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Provider Name | JUAN ALARCON MEDINA PA-C
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Gender | Male
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Dates
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Enumeration Date | 06/02/2022
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Last Update Date | 12/20/2025
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Provider Practice Location Address
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Address Line | 590 W PUTNAM AVE
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City | PORTERVILLE
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State | CA
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Zip | 93257-3257
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Country | US
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Telephone | 559-781-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 4646 BROCKTON AVE # 301A
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City | RIVERSIDE
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State | CA
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Zip | 92506-0102
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Country | US
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Telephone | 951-682-6900
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA64981
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License Number State | CA
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