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General NPI Number Information
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NPI Number | 1023380086
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Entity Type | Individual
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Provider Name | BABAK HOOSHMAND M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/06/2012
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 4472 S EASTERN AVE
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City | LAS VEGAS
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State | NV
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Zip | 89119-7825
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Country | US
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Telephone | 725-705-2739
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Fax | 702-331-2035
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Provider Business Mailing Address
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Address Line | PO BOX 530815
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City | HENDERSON
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State | NV
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Zip | 89053-0815
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Country | US
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Telephone | 725-705-2739
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Fax | 702-331-2035
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 14717
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 14717
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | AS3062508-60
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License Number State | MI
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