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General NPI Number Information
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NPI Number | 1013677624
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Entity Type | Organization
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Legal Business Name | DALILAH RESTREPO MD, A MEDICAL CORPORATION
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Dates
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Enumeration Date | 12/22/2021
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Last Update Date | 12/22/2021
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Provider Practice Location Address
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Address Line | 17100 EUCLID ST
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708
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Country | US
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Telephone | 917-376-0967
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Fax |
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Provider Business Mailing Address
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Address Line | 3334 E COAST HWY STE 655
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City | CORONA DEL MAR
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State | CA
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Zip | 92625-2328
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Country | US
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Telephone | 917-376-0967
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DALILAH RESTREPO
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Credential | MD
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Telephone | 917-376-0967
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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