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General NPI Number Information
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NPI Number | 1770655847
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Entity Type | Organization
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Legal Business Name | ALPHA CARE MEDICAL GROUP, INC
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 08/22/2019
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Provider Practice Location Address
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Address Line | 2589 E. WASHINGTON BLVD.
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City | PASADENA
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State | CA
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Zip | 91107
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Country | US
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Telephone | 626-798-8792
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Fax | 626-401-1671
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Provider Business Mailing Address
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Address Line | 1668 S. GARFIELD AVENUE, 2ND FLOOR
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City | ALHAMBRA
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State | CA
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Zip | 91801
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Country | US
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Telephone | 626-943-6228
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Fax | 626-943-6343
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DR. THOMAS LAM
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Credential | M.D., M.P.H.
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Telephone | 626-943-6228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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