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General NPI Number Information
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NPI Number | 1962690339
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Entity Type | Organization
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Legal Business Name | EUGENE C GROEGER,M.D. A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 10/10/2007
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Last Update Date | 08/06/2012
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Provider Practice Location Address
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Address Line | 2645 OCEAN AVE SUITE 307
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City | SAN FRANCISCO
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State | CA
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Zip | 94132-1633
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Country | US
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Telephone | 415-239-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 2645 OCEAN AVE SUITE 307
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City | SAN FRANCISCO
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State | CA
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Zip | 94132-1633
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Country | US
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Telephone | 415-239-2300
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. NUALA A ODONNELL
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Credential |
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Telephone | 415-239-2300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | G31287
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License Number State | CA
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