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General NPI Number Information
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NPI Number | 1922381755
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Entity Type | Organization
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Legal Business Name | JAMES L EDWARDS MD MEDICAL SERVICES INC
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Dates
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Enumeration Date | 09/28/2011
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Last Update Date | 09/28/2011
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Provider Practice Location Address
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Address Line | 3725 LONE TREE WAY SUITE C
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City | ANTIOCH
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State | CA
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Zip | 94509-6064
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Country | US
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Telephone | 925-754-1205
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Fax |
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Provider Business Mailing Address
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Address Line | 3725 LONE TREE WAY SUITE C
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City | ANTIOCH
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State | CA
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Zip | 94509-6064
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Country | US
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Telephone | 925-754-1205
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES EDWARDS
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Credential | MD
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Telephone | 925-754-1205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | A83531
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License Number State | CA
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