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General NPI Number Information
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NPI Number | 1881370658
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Entity Type | Individual
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Provider Name | CYNTHIA CAMILLE CARPO MUND OD
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Gender | Female
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Dates
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Enumeration Date | 06/26/2023
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 31361 RIVERSIDE DR
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City | LAKE ELSINORE
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State | CA
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Zip | 92530-7807
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Country | US
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Telephone | 951-252-2720
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Fax | 760-414-3892
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Provider Business Mailing Address
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Address Line | 1000 VALE TERRACE DR
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City | VISTA
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State | CA
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Zip | 92084-5218
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Country | US
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Telephone | 844-308-5003
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Fax | 760-414-3892
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 35502
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License Number State | CA
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