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General NPI Number Information
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NPI Number | 1902493448
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Entity Type | Organization
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Legal Business Name | JOHN C FREMONT HEALTHCARE DISTRICT
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Dates
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Enumeration Date | 12/30/2020
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Last Update Date | 12/30/2020
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Provider Practice Location Address
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Address Line | 5072 BULLION ST
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City | MARIPOSA
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State | CA
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Zip | 95338-2416
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Country | US
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Telephone | 209-742-7272
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 216
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City | MARIPOSA
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State | CA
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Zip | 95338-0216
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Country | US
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Telephone | 209-966-3631
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Fax | 209-672-6140
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Authorized Official
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Title or Position | MEDICAL STAFF COORDINATOR
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Name | ANNE-MARIE SHEELEY
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Credential |
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Telephone | 209-966-3631
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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