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General NPI Number Information
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NPI Number | 1245280940
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Entity Type | Individual
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Provider Name | FRED LELAND REITLER MD
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Gender | Male
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 11/12/2014
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Provider Practice Location Address
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Address Line | 3701 SKYPARK DR SUITE 100
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City | TORRANCE
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State | CA
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Zip | 90505-4753
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Country | US
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Telephone | 310-378-2234
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Fax | 310-378-9795
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Provider Business Mailing Address
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Address Line | 23326 HAWTHORNE BLVD SUITE 200
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City | TORRANCE
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State | CA
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Zip | 90505-3725
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Country | US
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Telephone | 310-257-7298
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Fax | 310-598-3117
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G35194
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License Number State | CA
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