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General NPI Number Information
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NPI Number | 1053552893
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Entity Type | Individual
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Provider Name | MONISH JATIN LAXPATI M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/06/2009
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Last Update Date | 07/21/2020
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Provider Practice Location Address
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Address Line | 2475 N GAREY AVE
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City | POMONA
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State | CA
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Zip | 91767-2139
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Country | US
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Telephone | 909-622-3166
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Fax | 909-622-8046
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Provider Business Mailing Address
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Address Line | 2475 N GAREY AVE
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City | POMONA
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State | CA
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Zip | 91767-2139
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Country | US
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Telephone | 909-622-3166
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Fax | 909-622-8046
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A106370
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License Number State | CA
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