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General NPI Number Information
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NPI Number | 1912444076
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Entity Type | Individual
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Provider Name | MANUEL JOSE AMADOR M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/27/2017
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Last Update Date | 01/27/2017
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Provider Practice Location Address
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Address Line | 9415 CAMPUS POINT DR
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City | LA JOLLA
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State | CA
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Zip | 92093-0946
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Country | US
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Telephone | 858-534-6290
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Fax |
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Provider Business Mailing Address
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Address Line | 5063 MILLAY CT
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City | CARLSBAD
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State | CA
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Zip | 92008-3869
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Country | US
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Telephone | 760-448-0722
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Fax |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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