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General NPI Number Information
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NPI Number | 1851739866
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Entity Type | Organization
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Legal Business Name | DIABLO PLAZA SURGERY CENTER
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Dates
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Enumeration Date | 06/12/2013
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Last Update Date | 06/12/2013
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Provider Practice Location Address
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Address Line | 2222 EAST ST STE 290
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City | CONCORD
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State | CA
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Zip | 94520-2066
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Country | US
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Telephone | 925-691-1580
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Fax | 925-689-2601
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Provider Business Mailing Address
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Address Line | 2222 EAST ST STE 290
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City | CONCORD
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State | CA
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Zip | 94520-2066
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Country | US
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Telephone | 925-691-1580
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Fax | 925-689-2601
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DR. KEVIN DEGNAN
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Credential | M.D.
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Telephone | 925-689-2580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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