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General NPI Number Information
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NPI Number | 1740938349
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Entity Type | Organization
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Legal Business Name | C4, INC.
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Dates
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Enumeration Date | 03/13/2022
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Last Update Date | 03/13/2022
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Provider Practice Location Address
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Address Line | 4623 THOMAS LAKE HARRIS DR UNIT 311
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City | SANTA ROSA
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State | CA
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Zip | 95403-0195
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Country | US
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Telephone | 402-517-2446
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Fax |
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Provider Business Mailing Address
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Address Line | 4623 THOMAS LAKE HARRIS DR UNIT 311
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City | SANTA ROSA
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State | CA
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Zip | 95403-0195
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Country | US
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Telephone | 402-517-2446
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MAULIN UPENDRA VORA
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Credential | MD
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Telephone | 402-517-2446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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