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General NPI Number Information
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NPI Number | 1801718309
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Entity Type | Organization
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Legal Business Name | LTID HOLDINGS, LLC
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Dates
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Enumeration Date | 07/27/2026
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Last Update Date | 07/27/2026
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Provider Practice Location Address
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Address Line | 13542 SECOND STREET REHAB ROOM
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City | YUCAIPA
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State | CA
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Zip | 92399-5396
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Country | US
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Telephone | 909-904-9048
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Fax | 323-900-0285
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Provider Business Mailing Address
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Address Line | 5545 BLUE RIDGE DR
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City | YORBA LINDA
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State | CA
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Zip | 92887-4251
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Country | US
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Telephone | 909-904-9048
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | EVANGELINE R POWELL
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Credential | RN
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Telephone | 909-904-9048
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225B00000X
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Taxonomy Name | Pulmonary Function Technologist
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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 | 2279P1005X
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Taxonomy Name | Pulmonary Rehabilitation Registered Respiratory Therapist
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License Number |
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License Number State |
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