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General NPI Number Information
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NPI Number | 1811927569
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Entity Type | Organization
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Legal Business Name | COVINA CANCER CARE MEDICAL CENTER, INC.
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 02/21/2020
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Provider Practice Location Address
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Address Line | 554 E SAN BERNARDINO RD STE. 105
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City | COVINA
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State | CA
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Zip | 91723-1747
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Country | US
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Telephone | 626-331-6866
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Fax | 626-331-6773
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Provider Business Mailing Address
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Address Line | 554 E SAN BERNARDINO RD STE. 105
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City | COVINA
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State | CA
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Zip | 91723-1747
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Country | US
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Telephone | 626-331-6866
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Fax | 626-331-6773
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Authorized Official
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Title or Position | CHIEF OF OPERATIONS
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Name | AMAR LAPSI
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Credential |
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Telephone | 626-331-6866
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | C50363
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License Number State | CA
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