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General NPI Number Information
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NPI Number | 1275764805
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Entity Type | Organization
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Legal Business Name | KAISER PERMANENTE
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Dates
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Enumeration Date | 07/30/2009
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Last Update Date | 07/30/2009
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Provider Practice Location Address
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Address Line | 6041 CADILLAC AVE
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City | LOS ANGELES
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State | CA
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Zip | 90034-1702
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Country | US
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Telephone | 323-857-2317
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Fax |
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Provider Business Mailing Address
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Address Line | 7554 SHIRLEY AVE
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City | RESEDA
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State | CA
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Zip | 91335-2448
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Country | US
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Telephone | 818-434-6397
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | MISS THAO PHUC LE
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Credential |
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Telephone | 818-434-6397
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 62623
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License Number State | CA
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