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General NPI Number Information
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NPI Number | 1174806111
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Entity Type | Individual
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Provider Name | MERVYN ALLEN SAHUD M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/26/2011
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Last Update Date | 04/05/2012
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Provider Practice Location Address
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Address Line | 2633 TELEGRAPH AVE #104
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City | OAKLAND
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State | CA
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Zip | 94612-1743
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Country | US
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Telephone | 510-830-3100
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Fax | 510-830-3316
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Provider Business Mailing Address
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Address Line | 4721 DALLAS RANCH RD
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City | ANTIOCH
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State | CA
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Zip | 94531-8811
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Country | US
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Telephone | 925-778-0679
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Fax | 925-778-3567
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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 | 207RH0000X
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Taxonomy Name | Hematology (Internal Medicine) Physician
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License Number | G11462
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License Number State | CA
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