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General NPI Number Information
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NPI Number | 1063523538
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Entity Type | Organization
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Legal Business Name | ADOBE MEDICAL GROUP INC.
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 220 W 1ST ST STE 102
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City | SANTA ANA
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State | CA
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Zip | 92701-5262
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Country | US
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Telephone | 714-550-7001
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Fax | 714-550-7006
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Provider Business Mailing Address
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Address Line | 2321 E FIRST ST STE 457
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City | SANTA ANA
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State | CA
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Zip | 92705
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Country | US
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Telephone | 714-550-7001
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Fax | 714-550-7006
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Authorized Official
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Title or Position | PRESIDENT
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Name | KAMRAN GHODSIAN
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Credential | MD
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Telephone | 714-662-1515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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