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General NPI Number Information
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NPI Number | 1164859120
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Entity Type | Organization
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Legal Business Name | CAVALLINI LLC
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Dates
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Enumeration Date | 10/03/2013
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Last Update Date | 10/03/2013
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Provider Practice Location Address
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Address Line | 7575 NORMAN ROCKWELL LN STE 110
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City | LAS VEGAS
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State | NV
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Zip | 89143-6014
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Country | US
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Telephone | 702-812-4605
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Fax | 702-898-4021
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Provider Business Mailing Address
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Address Line | 7575 NORMAN ROCKWELL LN STE 110
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City | LAS VEGAS
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State | NV
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Zip | 89143-6014
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Country | US
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Telephone | 702-812-4605
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Fax | 702-898-4021
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Authorized Official
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Title or Position | OWNER-
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Name | DR. FEROZAN MALAL
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Credential | MD
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Telephone | 702-812-4605
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 11605
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License Number State | NV
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