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General NPI Number Information
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NPI Number | 1023458528
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Entity Type | Individual
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Provider Name | DIANA MARIA MOKAYA M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/28/2013
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Last Update Date | 06/01/2023
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Provider Practice Location Address
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Address Line | 1080 EMELINE AVE
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City | SANTA CRUZ
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State | CA
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Zip | 95060-1966
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Country | US
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Telephone | 831-454-4491
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Fax |
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Provider Business Mailing Address
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Address Line | 3081 TEAGARDEN ST
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City | SAN LEANDRO
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State | CA
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Zip | 94577-5720
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Country | US
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Telephone | 510-347-4623
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A133542
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License Number State | CA
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