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NPI 1174987937

NPI 1174987937 : CAREN MOTIKA MCPHERSON LAC : LOS ANGELES, CA

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General NPI Number Information
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    NPI Number           |    1174987937
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    Entity Type          |    Individual 
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    Provider Name        |    CAREN MOTIKA MCPHERSON LAC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/07/2016
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    Last Update Date     |    04/07/2016
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Provider Practice Location Address
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    Address Line         |    4706 EAGLE ROCK BLVD 
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90041-2712
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    Country              |    US
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    Telephone            |    323-507-2060
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    841 GANYMEDE DR 
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90065-3345
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    Country              |    US
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    Telephone            |    310-486-1264
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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        |    171100000X
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    Taxonomy Name        |    Acupuncturist
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    License Number       |    16674
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    License Number State |    CA
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