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General NPI Number Information
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NPI Number | 1265965677
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Entity Type | Individual
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Provider Name | BRIAN KELLY COX M.D., M.A.S.
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Gender | Male
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Dates
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Enumeration Date | 04/04/2017
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Last Update Date | 06/07/2022
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Provider Practice Location Address
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Address Line | 9295 FARNHAM ST
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City | SAN DIEGO
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State | CA
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Zip | 92123-1254
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Country | US
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Telephone | 760-207-7768
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Fax |
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Provider Business Mailing Address
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Address Line | FILE 1440
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City | PASADENA
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State | CA
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Zip | 91199-1440
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Country | US
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Telephone | 760-207-7768
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | A166895
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License Number State | CA
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