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General NPI Number Information
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NPI Number | 1790501393
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Entity Type | Organization
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Legal Business Name | MEDEX CITY NETWORK
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Dates
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Enumeration Date | 11/27/2024
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Last Update Date | 11/27/2024
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Provider Practice Location Address
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Address Line | 12165 1ST ST
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City | YUCAIPA
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State | CA
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Zip | 92399-4357
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Country | US
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Telephone | 909-809-0289
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Fax | 855-233-7921
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Provider Business Mailing Address
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Address Line | 1605 VALLE DEL SOL
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City | REDLANDS
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State | CA
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Zip | 92373-7438
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Country | US
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Telephone | 909-809-0289
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Fax | 855-233-7921
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | DR. JUN RATUNIL CHIONG
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Credential | MD, MPH
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Telephone | 909-809-0289
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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