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General NPI Number Information
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NPI Number | 1093864373
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Entity Type | Individual
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Provider Name | SOE TIN MAUNGLAY MD
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Gender | Male
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 09/08/2020
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Provider Practice Location Address
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Address Line | 4500 BROCKTON AVE STE 316
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City | RIVERSIDE
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State | CA
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Zip | 92501-4090
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Country | US
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Telephone | 951-394-3055
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Fax | 951-394-3077
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Provider Business Mailing Address
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Address Line | 51753 EL DORADO DR
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City | LA QUINTA
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State | CA
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Zip | 92253-9034
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Country | US
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Telephone | 760-619-2309
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Fax | 866-428-0708
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | C152411
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License Number State | CA
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