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1700460938
REQUEIJO-GAMBOA EPC ACO LLC
CARSON CITY, NV
NPI
1700460938
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Entity Type
Organization
Authorized Contact
ANTONIO GAMBOA
Owner
737-226-6700
Organization Subpart ?
No
Primary Taxonomy
207R00000X Internal Medicine
Enumeration Date
2021-05-12
Last Update Date
2021-05-12
Business Address
REQUEIJO-GAMBOA EPC ACO LLC
1001 MOUNTAIN ST
CARSON CITY, NV 89703-3848
Phone number: 737-226-6700
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Mailing Address
REQUEIJO-GAMBOA EPC ACO LLC
3901A SPICEWOOD SPRINGS RD STE 201
AUSTIN, TX 78759-8728
Phone number: 737-226-6700
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