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General NPI Number Information
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NPI Number | 1013960475
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Entity Type | Individual
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Provider Name | JACK SHIH-CHIEH KAO M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 03/02/2015
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Provider Practice Location Address
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Address Line | 1155 S GRAND AVE APT 1212
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City | LOS ANGELES
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State | CA
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Zip | 90015-2789
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Country | US
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Telephone | 714-309-6697
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Fax |
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Provider Business Mailing Address
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Address Line | 1155 S GRAND AVE APT 1212
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City | LOS ANGELES
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State | CA
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Zip | 90015-2789
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Country | US
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Telephone | 714-309-6697
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 219901
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A69438
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A69438
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License Number State | CA
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