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General NPI Number Information
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NPI Number | 1942983473
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Entity Type | Organization
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Legal Business Name | DR CARNEIRO WOUND MEDICINE CORP
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Dates
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Enumeration Date | 08/10/2023
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Last Update Date | 08/17/2023
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Provider Practice Location Address
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Address Line | 1628 PALM AVE
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City | SAN DIEGO
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State | CA
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Zip | 92154-1027
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Country | US
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Telephone | 303-513-8725
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Fax |
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Provider Business Mailing Address
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Address Line | 2220 OTAY LAKES RD STE 502-340
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City | CHULA VISTA
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State | CA
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Zip | 91915-1004
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Country | US
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Telephone | 303-513-8725
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CARMEN ANGELICA CARNEIRO-ROJAS
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Credential | MD
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Telephone | 303-513-8725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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