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General NPI Number Information
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NPI Number | 1104977693
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Entity Type | Individual
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Provider Name | CONNIE CHOI O.D.
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Gender | Female
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Dates
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Enumeration Date | 01/13/2007
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Last Update Date | 12/07/2016
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Provider Practice Location Address
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Address Line | 30600 DYER ST
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City | UNION CITY
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State | CA
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Zip | 94587-1717
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Country | US
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Telephone | 510-441-7403
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Fax |
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Provider Business Mailing Address
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Address Line | 308 VICTORIA BAY
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City | ALAMEDA
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State | CA
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Zip | 94502-6522
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Country | US
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Telephone | 510-589-9758
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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 | 12903T
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License Number State | CA
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