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General NPI Number Information
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NPI Number | 1932577434
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Entity Type | Individual
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Provider Name | MATEO SOLOMON ARROLIGA CRNA
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Gender | Male
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Dates
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Enumeration Date | 09/14/2015
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Last Update Date | 03/23/2018
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Provider Practice Location Address
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Address Line | 2101 N WATERMAN AVE
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City | SAN BERNARDINO
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State | CA
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Zip | 92404-4836
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Country | US
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Telephone | 856-534-9073
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Fax |
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Provider Business Mailing Address
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Address Line | 1967 SW RIVER SQ
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City | PORTLAND
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State | OR
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Zip | 97201-8023
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Country | US
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Telephone | 856-534-9073
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 201502800RN
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | NA950008666
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License Number State | CA
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