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General NPI Number Information
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NPI Number | 1144625823
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Entity Type | Individual
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Provider Name | LUKE WON
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Gender | Male
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Dates
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Enumeration Date | 10/24/2014
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Last Update Date | 09/25/2019
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Provider Practice Location Address
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Address Line | 520 N MAIN ST STE 120
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City | SANTA ANA
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State | CA
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Zip | 92701-4623
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Country | US
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Telephone | 714-352-5800
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Fax | 714-352-5801
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Provider Business Mailing Address
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Address Line | 1567 215TH ST FL 2
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City | BAYSIDE
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State | NY
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Zip | 11360-1238
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Country | US
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Telephone | 510-502-6046
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E5409
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License Number State | CA
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