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General NPI Number Information
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NPI Number | 1225680242
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Entity Type | Individual
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Provider Name | ELAINE L WU OD
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Gender | Female
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Dates
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Enumeration Date | 07/10/2019
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Last Update Date | 07/12/2019
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Provider Practice Location Address
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Address Line | 299 SOUTHLAND MALL
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City | HAYWARD
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State | CA
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Zip | 94545-2129
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Country | US
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Telephone | 510-782-8911
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Fax |
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Provider Business Mailing Address
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Address Line | 1577 BRUNSWIG LN
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City | EMERYVILLE
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State | CA
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Zip | 94608-2406
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Country | US
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Telephone | 626-560-9427
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 34264TLG
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License Number State | CA
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