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General NPI Number Information
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NPI Number | 1740336981
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Entity Type | Organization
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Legal Business Name | EMMANUEL T. FABELLA, M.D., INC.
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Dates
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Enumeration Date | 01/27/2007
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Last Update Date | 10/06/2008
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Provider Practice Location Address
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Address Line | 880 E MERRITT AVE SUITE 102
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City | TULARE
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State | CA
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Zip | 93274-2244
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Country | US
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Telephone | 559-687-8200
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2053
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City | TULARE
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State | CA
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Zip | 93275-2053
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Country | US
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Telephone | 559-687-8200
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. EMMANUEL T. FABELLA
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Credential | M.D.
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Telephone | 559-687-8200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C51956
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License Number State |
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