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1164165031
EVAN ALEXANDER BASICAL
FONTANA, CA
NPI
1164165031
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2022-04-18
Last Update Date
2022-08-24
Business Address
EVAN ALEXANDER BASICAL
17234 VALLEY BOULEVARD BUILDING A
FONTANA, CA 92335-6720
Phone number: 909-427-4128
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Mailing Address
EVAN ALEXANDER BASICAL
17234 VALLEY BOULEVARD BUILDING A
FONTANA, CA 92335-6720
Phone number:
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