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General NPI Number Information
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NPI Number | 1972248441
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Entity Type | Organization
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Legal Business Name | RAVINDER SINGH BAJWA, M.D, INC
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Dates
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Enumeration Date | 04/29/2022
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Last Update Date | 04/29/2022
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Provider Practice Location Address
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Address Line | 4904 TELEGRAPH RD
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City | VENTURA
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State | CA
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Zip | 93003-4109
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Country | US
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Telephone | 805-642-4101
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Fax |
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Provider Business Mailing Address
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Address Line | 5302 CALAROSA RANCH RD
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City | CAMARILLO
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State | CA
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Zip | 93012-2541
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Country | US
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Telephone | 951-461-9573
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Fax | 951-304-3653
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Authorized Official
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Title or Position | THIRD PARTY ADMINISTRATOR
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Name | MRS. TRACY GALLO
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Credential |
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Telephone | 951-461-9573
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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