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General NPI Number Information
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NPI Number | 1770307464
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Entity Type | Organization
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Legal Business Name | CALIFORNIA COLLEGE OF PHYSICAL ARTS, INC.
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Dates
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Enumeration Date | 11/11/2024
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 18582 BEACH BLVD STE 11
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92648-2071
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Country | US
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Telephone | 714-964-7744
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Fax | 714-500-0949
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Provider Business Mailing Address
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Address Line | 18582 BEACH BLVD STE 11
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92648-2071
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Country | US
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Telephone | 714-964-7744
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Fax | 714-500-0949
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. MICHELLE MARIE MANGANO
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Credential | CMT
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Telephone | 714-964-7744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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