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General NPI Number Information
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NPI Number | 1215071907
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Entity Type | Individual
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Provider Name | ROSA M. DEL VALLE M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 7542 LAUREL CANYON BLVD
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91605-3148
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Country | US
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Telephone | 818-765-0503
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Fax | 818-765-3842
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Provider Business Mailing Address
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Address Line | 18027 MARTHA ST
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City | ENCINO
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State | CA
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Zip | 91316-1052
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Country | US
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Telephone | 818-758-3447
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A48945
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License Number State | CA
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