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General NPI Number Information
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NPI Number | 1144329640
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Entity Type | Organization
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Legal Business Name | SHLYAKHOV SMILEY OPTOMETRISTS, INC.
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 08/12/2009
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Provider Practice Location Address
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Address Line | 701 HOWE AVE STE G48
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City | SACRAMENTO
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State | CA
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Zip | 95825-4604
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Country | US
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Telephone | 916-921-8080
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Fax |
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Provider Business Mailing Address
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Address Line | 701 HOWE AVE STE G48
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City | SACRAMENTO
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State | CA
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Zip | 95825-4604
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Country | US
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Telephone | 916-921-8080
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | DR. THOMAS P. SMILEY
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Credential | O.D.
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Telephone | 916-921-8080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 7061T
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License Number State | CA
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