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NPI 1235548751

NPI 1235548751 : NISHA MALHOTRA, MD, LLC : HONOLULU, HI

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General NPI Number Information
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    NPI Number           |    1235548751
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    Entity Type          |    Organization 
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    Legal Business Name  |    NISHA MALHOTRA, MD, LLC 
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Dates
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    Enumeration Date     |    08/08/2014
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    Last Update Date     |    08/08/2014
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Provider Practice Location Address
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    Address Line         |    1329 LUSITANA ST SUITE 604
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    City                 |    HONOLULU
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    State                |    HI
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    Zip                  |    96813-2429
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    Country              |    US
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    Telephone            |    808-531-1116
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    Fax                  |    808-524-7911
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Provider Business Mailing Address
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    Address Line         |    1329 LUSITANA ST SUITE 604
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    City                 |    HONOLULU
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    State                |    HI
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    Zip                  |    96813-2429
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    Country              |    US
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    Telephone            |    808-531-1116
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    Fax                  |    808-524-7911
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Authorized Official
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    Title or Position    |    MEMBER
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    Name                 |    DR. NISHA  MALHOTRA 
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    Credential           |    M.D.
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    Telephone            |    630-460-6474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207L00000X
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    Taxonomy Name        |    Anesthesiology Physician
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    License Number       |    17576
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    License Number State |    HI
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