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General NPI Number Information
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NPI Number | 1740492701
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Entity Type | Organization
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Legal Business Name | WESTSIDE HEALTH CARE, LLC
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 09/15/2014
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Provider Practice Location Address
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Address Line | 1020 S FAIRFAX AVE
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City | LOS ANGELES
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State | CA
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Zip | 90019-4401
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Country | US
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Telephone | 323-938-2451
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Fax | 323-938-0361
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Provider Business Mailing Address
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Address Line | 1020 S FAIRFAX AVE
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City | LOS ANGELES
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State | CA
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Zip | 90019-4401
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Country | US
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Telephone | 323-938-2451
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Fax | 323-938-0361
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Authorized Official
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Title or Position | CONTROLLER
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Name | HELEN STURGEON
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Credential |
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Telephone | 323-938-2451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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