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General NPI Number Information
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NPI Number | 1992032122
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Entity Type | Organization
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Legal Business Name | SHORECLIFFS MEDICAL GROUP INC
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Dates
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Enumeration Date | 11/09/2009
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Last Update Date | 11/09/2009
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Provider Practice Location Address
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Address Line | 161 AVENIDA VAQUERO
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City | SAN CLEMENTE
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State | CA
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Zip | 92672-3601
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Country | US
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Telephone | 949-489-8783
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Fax | 949-493-9888
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Provider Business Mailing Address
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Address Line | 161 AVENIDA VAQUERO
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City | SAN CLEMENTE
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State | CA
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Zip | 92672-3601
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Country | US
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Telephone | 949-489-8783
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Fax | 949-493-9888
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Authorized Official
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Title or Position | OWNER
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Name | INCHEL YEAM
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Credential | MD
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Telephone | 949-489-8783
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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 | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) 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 | 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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