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General NPI Number Information
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NPI Number | 1073754974
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Entity Type | Organization
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Legal Business Name | BENJAMIN S THRELKELD
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Dates
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Enumeration Date | 03/23/2009
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Last Update Date | 03/01/2023
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Provider Practice Location Address
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Address Line | 250 CAMBRIDGE AVE SUITE 102
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City | PALO ALTO
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State | CA
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Zip | 94306-1549
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Country | US
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Telephone | 650-323-6772
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Fax | 650-323-6775
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Provider Business Mailing Address
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Address Line | 250 CAMBRIDGE AVE SUITE 102
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City | PALO ALTO
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State | CA
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Zip | 94306-1549
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Country | US
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Telephone | 650-323-6772
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Fax | 650-323-6775
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. CINDY HSIAO THRELKELD
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Credential | OD
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Telephone | 650-323-6772
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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 | 11147T
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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 | 11278T
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License Number State | CA
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