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General NPI Number Information
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NPI Number | 1760423180
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Entity Type | Organization
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Legal Business Name | CENTRAL COAST ENDOSCOPY CENTER INC
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Dates
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Enumeration Date | 06/09/2006
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Last Update Date | 02/07/2023
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Provider Practice Location Address
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Address Line | 243 GREEN VALLEY RD STE F
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City | FREEDOM
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State | CA
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Zip | 95019-3133
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Country | US
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Telephone | 831-763-0407
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Fax | 831-763-0101
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Provider Business Mailing Address
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Address Line | 1081 LOS PALOS DR
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City | SALINAS
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State | CA
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Zip | 93901-3916
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Country | US
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Telephone | 831-763-0407
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Fax | 831-763-0101
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Authorized Official
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Title or Position | DIRECTOR
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Name | STEVEN G JOHNSON
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Credential | MD
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Telephone | 831-800-7887
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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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