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General NPI Number Information
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NPI Number | 1043964232
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Entity Type | Individual
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Provider Name | PHOEBE NHI LUONG OD
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Gender | Female
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Dates
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Enumeration Date | 02/08/2022
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Last Update Date | 09/26/2023
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Provider Practice Location Address
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Address Line | 9515 W CAMELBACK RD STE 110
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City | PHOENIX
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State | AZ
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Zip | 85037-1365
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Country | US
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Telephone | 623-937-1655
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Fax |
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Provider Business Mailing Address
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Address Line | 20 TIDEWATER CV
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City | BUENA PARK
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State | CA
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Zip | 90621-1661
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Country | US
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Telephone | 626-213-7659
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 34833
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 002539
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License Number State | AZ
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