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1023762259
SHANE SAPUTRA
SAN JOSE, CA
NPI
1023762259
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
163W00000X Registered Nurse
(Licence: CA 95260284)
Enumeration Date
2022-02-07
Last Update Date
2022-02-07
Business Address
SHANE SAPUTRA
425 E SANTA CLARA ST
SAN JOSE, CA 95113-1936
Phone number: 669-245-3429
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Mailing Address
SHANE SAPUTRA
425 E SANTA CLARA ST
SAN JOSE, CA 95113-1936
Phone number:
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