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General NPI Number Information
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NPI Number | 1083044192
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Entity Type | Organization
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Legal Business Name | OHNI CLINICAL SERVICES, INC
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Dates
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Enumeration Date | 11/26/2013
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Last Update Date | 11/26/2013
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Provider Practice Location Address
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Address Line | 8631 W 3RD ST SUITE 945E
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City | LOS ANGELES
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State | CA
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Zip | 90048-5901
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Country | US
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Telephone | 310-657-0123
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Fax | 310-657-0142
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Provider Business Mailing Address
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Address Line | PO BOX 45345
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City | LOS ANGELES
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State | CA
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Zip | 90045-0345
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Country | US
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Telephone | 310-657-0123
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Fax | 310-657-0142
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Authorized Official
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Title or Position | BUSINESS ADMINISTRATOR
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Name | MRS. KIM YVETTE GALES
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Credential |
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Telephone | 310-657-0123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 070788
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A64640
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 21319
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A64640
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License Number State | CA
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