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General NPI Number Information
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NPI Number | 1255843199
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Entity Type | Organization
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Legal Business Name | DANIEL T KHONG, OD, APOC
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Dates
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Enumeration Date | 11/01/2017
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Last Update Date | 07/16/2020
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Provider Practice Location Address
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Address Line | 2645 MANHATTAN BLVD STE E2B
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City | HARVEY
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State | LA
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Zip | 70058-3375
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Country | US
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Telephone | 504-309-8619
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Fax | 504-218-4190
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Provider Business Mailing Address
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Address Line | 3409 WILLIAMS BLVD STE 5
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City | KENNER
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State | LA
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Zip | 70065-3879
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Country | US
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Telephone | 504-466-0271
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Fax | 504-466-3011
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL KHONG
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Credential | OD
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Telephone | 504-466-0271
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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 | 1185-338T
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License Number State | LA
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