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CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY DEPARTMENT OF PUBLIC HEALTH STATEMENT OF DEFICIENCIES ANO PLAN OF CORRECTIONX1) PROVIDER/SUPPLIER/CUA IDENTIFICATION NUMBER:(X2) MULTIPLE CONSTRUCTIONX3)

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Any individual or organization who wishes to become a provider or supplier in a specific field or industry needs x1 providersuppliercua.

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What is x1 providersuppliercua?

X1 providersuppliercua is a form used to collect information about providers and suppliers.

Who is required to file x1 providersuppliercua?

All healthcare providers and suppliers are required to file x1 providersuppliercua.

How to fill out x1 providersuppliercua?

X1 providersuppliercua can be filled out electronically or manually, depending on the preference of the provider or supplier.

What is the purpose of x1 providersuppliercua?

The purpose of x1 providersuppliercua is to gather data about healthcare providers and suppliers for regulatory purposes.

What information must be reported on x1 providersuppliercua?

Information such as provider/supplier name, address, contact information, services offered, and other relevant details must be reported on x1 providersuppliercua.

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