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General NPI Number Information
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NPI Number | 1134294788
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Entity Type | Organization
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Legal Business Name | LUIS E RUIZ-RESTREPO MD INC
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 03/23/2011
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Provider Practice Location Address
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Address Line | 116 WEST E. STREET
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City | TEHACHAPI
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State | CA
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Zip | 93561
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Country | US
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Telephone | 661-822-1004
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Fax | 661-822-3603
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Provider Business Mailing Address
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Address Line | PO BOX 663
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City | TEHACHAPI
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State | CA
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Zip | 93581-0663
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Country | US
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Telephone | 661-822-1004
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Fax | 661-822-3603
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Authorized Official
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Title or Position | CEO
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Name | LUIS E. RUIZ-RESTREPO
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Credential | M.D.
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Telephone | 661-822-1004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | C41382
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License Number State | CA
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