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Get Dhcs 6248 Form

Rding participation in the Medi-Cal program. Please complete the enclosed Medi-Cal provider enrollment application package and return it to: Department of Health Care Services Provider Enrollment Division MS 4704 P.O. Box 997412 Sacramento, California, 95899-7412 Please read all the instructions included in the application package carefully and complete each item requested. Incomplete application packages will be returned. PLEASE NOTE: Applicants and providers are required to submit their Nation.

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