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General NPI Number Information
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NPI Number | 1841069192
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Entity Type | Organization
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Legal Business Name | SANDYCARE INC
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Dates
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Enumeration Date | 12/28/2023
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Last Update Date | 01/04/2024
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Provider Practice Location Address
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Address Line | 5440 MOREHOUSE DR STE 2700
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City | SAN DIEGO
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State | CA
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Zip | 92121-6709
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Country | US
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Telephone | 858-422-0770
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Fax |
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Provider Business Mailing Address
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Address Line | 5440 MOREHOUSE DR STE 2700
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City | SAN DIEGO
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State | CA
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Zip | 92121-6709
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KIM MALLER
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Credential |
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Telephone | 858-422-0772
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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