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General NPI Number Information
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NPI Number | 1962554873
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Entity Type | Organization
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Legal Business Name | ALTA BATES SUMMIT MEDICAL CENTER ADULT DAY CARE
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 04/21/2016
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Provider Practice Location Address
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Address Line | 350 HAWTHORNE AVE
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City | OAKLAND
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State | CA
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Zip | 94609-3108
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Country | US
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Telephone | 510-204-4444
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 742920
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City | LOS ANGELES
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State | CA
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Zip | 90074-2920
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Country | US
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Telephone | 855-398-1633
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Fax |
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Authorized Official
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Title or Position | CFO SHBA
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Name | JOHN GATES
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Credential |
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Telephone | 510-450-7357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State | CA
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