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1447843495
JUSTIN PATRICK BACOLOR
SAN JOSE, CA
NPI
1447843495
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2021-02-19
Last Update Date
2021-02-19
Business Address
JUSTIN PATRICK BACOLOR
55 E JULIAN ST
SAN JOSE, CA 95112-4007
Phone number: 408-918-2667
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Mailing Address
JUSTIN PATRICK BACOLOR
2658 WILDHORSE TRAIL WAY
CHULA VISTA, CA 91915-2542
Phone number: 619-488-7430
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