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20370 W Valley Blvd Tehachapi CA 93561-8615 | |
(661) 822-3727 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 20370 W Valley Blvd, Tehachapi, California |
Authorized Official Name and Position | Jose David Sanchez (PRESIDENT) |
Authorized Official Contact | 7144859999 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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20370 W Valley Blvd Tehachapi CA 93561-8615 Ph: () - | 20370 W Valley Blvd Tehachapi CA 93561-8615 Ph: (661) 822-3727 |
NPI Number | 1922767557 |
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Provider Enumeration Date | 12/10/2021 |
Last Update Date | 09/19/2022 |
Medicare PECOS PAC ID | 5294111548 |
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Medicare Enrollment ID | O20221010003122 |
Identifier | Type | State | Issuer |
---|---|---|---|
1922767557 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Provider Name | Jose D Sanchez |
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Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1336206788 PECOS PAC ID: 0042364507 Enrollment ID: I20090818000393 |
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