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General NPI Number Information
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NPI Number | 1053706283
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Entity Type | Individual
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Provider Name | GELAREH RAHBAR D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 04/03/2015
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Last Update Date | 04/03/2015
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Provider Practice Location Address
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Address Line | 133 KEARNY ST STE 204
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City | SAN FRANCISCO
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State | CA
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Zip | 94108-4809
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Country | US
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Telephone | 415-986-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 LAKESHORE AVE APT 18H
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City | OAKLAND
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State | CA
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Zip | 94606-1629
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Country | US
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Telephone | 415-385-5775
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Fax | 415-276-6370
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 42765
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License Number State | CA
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