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General NPI Number Information
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NPI Number | 1124281761
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Entity Type | Individual
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Provider Name | WAYNE SARKIS DODAKIAN D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/03/2008
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Last Update Date | 12/04/2014
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Provider Practice Location Address
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Address Line | 5451 WALNUT AVE
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City | CHINO
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State | CA
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Zip | 91710-2609
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Country | US
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Telephone | 909-464-8880
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Fax |
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Provider Business Mailing Address
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Address Line | 16572 WANDERER LN
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92649-2144
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Country | US
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Telephone | 626-807-8227
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 20A12340
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License Number State | CA
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