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General NPI Number Information
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NPI Number | 1760147318
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Entity Type | Organization
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Legal Business Name | NBASC
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Dates
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Enumeration Date | 11/08/2021
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Last Update Date | 08/18/2023
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Provider Practice Location Address
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Address Line | 1850 SULLIVAN AVE STE 400
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City | DALY CITY
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State | CA
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Zip | 94015-2204
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Country | US
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Telephone | 408-828-5973
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Fax | 866-284-9263
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Provider Business Mailing Address
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Address Line | PO BOX 1312
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City | LOS GATOS
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State | CA
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Zip | 95031-1312
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Country | US
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Telephone | 408-828-5973
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. CHRISTOPHER VIALE
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Credential | MD
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Telephone | 408-828-5973
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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