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General NPI Number Information
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NPI Number | 1144391293
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Entity Type | Individual
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Provider Name | MICHEAL THOMPSON MD
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Gender | Male
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Dates
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Enumeration Date | 11/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4023 W BURBANK BLVD
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City | BURBANK
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State | CA
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Zip | 91505-2120
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Country | US
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Telephone | 818-845-0023
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Fax | 818-845-0324
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Provider Business Mailing Address
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Address Line | PO BOX 218
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City | LEMOORE
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State | CA
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Zip | 93245-0218
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Country | US
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Telephone | 559-904-6908
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G56271
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License Number State | CA
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