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NPI 1255306098

NPI 1255306098 : RICHARD D ZUMWALT : PARADISE, CA

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General NPI Number Information
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    NPI Number           |    1255306098
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    Entity Type          |    Individual 
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    Provider Name        |    RICHARD D ZUMWALT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/22/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    6283 CLARK RD #9
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    City                 |    PARADISE
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    State                |    CA
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    Zip                  |    95969-4100
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    Country              |    US
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    Telephone            |    530-872-0617
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    Fax                  |    530-872-4463
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Provider Business Mailing Address
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    Address Line         |    6765 CHAPMAN LN 
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    City                 |    PARADISE
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    State                |    CA
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    Zip                  |    95969-2305
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    Country              |    US
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    Telephone            |    530-872-4326
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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        |    207N00000X
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    Taxonomy Name        |    Dermatology Physician
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    License Number       |    G40946
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    License Number State |    CA
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