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General NPI Number Information
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NPI Number | 1194928010
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Entity Type | Individual
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Provider Name | SONYA MITROVICH M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 26671 ALISO CREEK RD SUITE304
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City | ALISO VIEJO
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State | CA
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Zip | 92656-4809
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Country | US
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Telephone | 949-831-3686
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Fax |
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Provider Business Mailing Address
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Address Line | 31 VISTA TRAMONTO
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City | NEWPORT COAST
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State | CA
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Zip | 92657-1402
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Country | US
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Telephone | 949-394-2763
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | G87431
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License Number State | CA
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