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General NPI Number Information
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NPI Number | 1114233160
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Entity Type | Organization
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Legal Business Name | ISMAIL CENTER INC
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Dates
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Enumeration Date | 08/28/2010
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Last Update Date | 03/11/2011
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Provider Practice Location Address
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Address Line | 1711 W TEMPLE ST # 5606
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City | LOS ANGELES
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State | CA
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Zip | 90026-5421
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Country | US
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Telephone | 323-304-7248
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Fax |
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Provider Business Mailing Address
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Address Line | 8391 BEVERLY BLVD STE202
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City | LOS ANGELES
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State | CA
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Zip | 90048-2633
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Country | US
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Telephone | 323-304-7248
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. MOHAMED HANI ISMAIL
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Credential | M.D.
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Telephone | 323-304-7248
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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 | A87963
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License Number State |
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