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General NPI Number Information
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NPI Number | 1104621093
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Entity Type | Individual
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Provider Name | SHEILA JAVADI OD
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Gender | Female
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Dates
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Enumeration Date | 02/15/2025
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Last Update Date | 02/15/2025
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Provider Practice Location Address
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Address Line | 10740 FOOTHILL BLVD
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-3862
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Country | US
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Telephone | 909-942-3030
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6021
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City | FULLERTON
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State | CA
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Zip | 92834-6021
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Country | US
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Telephone | 714-765-9595
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Fax |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 35913
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License Number State | CA
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