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General NPI Number Information
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NPI Number | 1164221685
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Entity Type | Organization
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Legal Business Name | ASHKAN SALAMATIPOUR, DO, INC
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Dates
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Enumeration Date | 03/08/2025
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 5153 HOLT BLVD STE B1
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City | MONTCLAIR
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State | CA
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Zip | 91763-4837
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Country | US
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Telephone | 909-603-9000
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Fax | 909-603-9008
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Provider Business Mailing Address
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Address Line | 3334 E COAST HWY # 436
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City | CORONA DEL MAR
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State | CA
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Zip | 92625-2328
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | ASHKAN SALAMATIPOUR
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Credential | DO
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Telephone | 909-603-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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