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General NPI Number Information
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NPI Number | 1083673685
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Entity Type | Individual
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Provider Name | WILLIAM COKE HARRELL MD
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Gender | Male
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Dates
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Enumeration Date | 03/22/2006
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 10861 CHERRY ST STE 209
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-5407
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Country | US
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Telephone | 310-948-5903
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Fax | 310-315-7933
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Provider Business Mailing Address
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Address Line | 2118 WILSHIRE BLVD #1122
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City | SANTA MONICA
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State | CA
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Zip | 90403-5704
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Country | US
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Telephone | 310-315-7922
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Fax | 310-315-7933
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G64492
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License Number State | CA
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