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General NPI Number Information
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NPI Number | 1770859118
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Entity Type | Organization
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Legal Business Name | CLARICE CAMPOSANO CALOPIZ, MD, INC
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Dates
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Enumeration Date | 03/29/2012
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Last Update Date | 03/29/2012
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Provider Practice Location Address
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Address Line | 1213 EATON AVE SUITE 6
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City | SAN CARLOS
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State | CA
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Zip | 94070-5233
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Country | US
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Telephone | 650-593-7861
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Fax | 650-593-6144
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Provider Business Mailing Address
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Address Line | 3875 CARTER DR NO. 205
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City | SOUTH SAN FRANCISCO
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State | CA
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Zip | 94080-3886
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Country | US
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Telephone | 650-867-7136
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. CLARICE CAMPOSANO CALOPIZ
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Credential | MD
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Telephone | 650-867-7136
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A92245
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License Number State | CA
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