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General NPI Number Information
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NPI Number | 1134381619
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Entity Type | Individual
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Provider Name | LOURDES G BAHAMONDE DO
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Gender | Female
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Dates
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Enumeration Date | 06/26/2008
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Last Update Date | 11/30/2021
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Provider Practice Location Address
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Address Line | 7643 ATLANTIC AVE
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City | CUDAHY
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State | CA
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Zip | 90201-5019
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Country | US
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Telephone | 213-373-1265
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Fax |
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Provider Business Mailing Address
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Address Line | 147 N MAYFLOWER AVE
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City | MONROVIA
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State | CA
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Zip | 91016-2005
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Country | US
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Telephone | 516-526-9192
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 254878
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 20A13517
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License Number State | CA
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