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General NPI Number Information
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NPI Number | 1245649623
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Entity Type | Individual
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Provider Name | RAJIV KOTHARI
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Gender | Male
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Dates
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Enumeration Date | 08/11/2014
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Last Update Date | 08/11/2014
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Provider Practice Location Address
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Address Line | 3095 MCMURRAY DR
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City | ANDERSON
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State | CA
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Zip | 96007-3674
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Country | US
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Telephone | 530-365-5753
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Fax |
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Provider Business Mailing Address
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Address Line | 1504 FALCON POINTE LN
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City | ROSEVILLE
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State | CA
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Zip | 95661-4009
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Country | US
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Telephone | 916-791-7679
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 42367
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License Number State | CA
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