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General NPI Number Information
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NPI Number | 1831159730
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Entity Type | Individual
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Provider Name | JOCELYN SANTOS
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Gender | Female
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 12/01/2014
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Provider Practice Location Address
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Address Line | 101 CIVIC CENTER LN APOGEE PHYSICIANS OFFICE
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-5607
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Country | US
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Telephone | 928-302-5402
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Fax | 928-302-5906
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Provider Business Mailing Address
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Address Line | 2525 E CAMELBACK RD SUITEN1100
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City | PHOENIX
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State | AZ
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Zip | 85016-4219
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Country | US
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Telephone | 602-618-9112
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Fax | 602-778-3619
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 27105
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License Number State | AZ
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