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General NPI Number Information
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NPI Number | 1972811412
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Entity Type | Individual
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Provider Name | ROBERT PAUL PA
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Gender | Male
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Dates
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Enumeration Date | 09/17/2010
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 340 FOURTH AVE STE 19
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City | CHULA VISTA
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State | CA
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Zip | 91910-3898
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Country | US
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Telephone | 619-761-5308
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Fax | 619-591-1910
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Provider Business Mailing Address
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Address Line | 10565 CIVIC CENTER DR STE 250
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-3854
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Country | US
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Telephone | 626-696-1400
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Fax | 626-696-1451
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 22368
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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