PHYSICIAN Initial Credentialing Checklist

Medi-Cal Enrollment Verification-by NPI Source: Medi-Cal.gov. NA. License to Practice (if copy of card is submitted, not required) License Verification Source: CA DCA Breeze. S. econdary License Actions? Y. or. N. DEA/CDS Certificate Suboxone Y or N (If yes, confirm addendum is behind ... ................
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