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General NPI Number Information
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NPI Number | 1205923224
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Entity Type | Individual
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Provider Name | MICHAEL SHAWN VALDEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 08/26/2024
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Provider Practice Location Address
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Address Line | 2743 ORANGE ST
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City | RIVERSIDE
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State | CA
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Zip | 92501-2503
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Country | US
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Telephone | 800-300-7326
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 50042
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City | LOS ANGELES
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State | CA
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Zip | 90074-0001
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Country | US
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Telephone | 818-893-3384
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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 | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | G79406
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number | G79406
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License Number State | CA
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