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General NPI Number Information
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NPI Number | 1285017699
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Entity Type | Individual
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Provider Name | DINIKA BAGGA
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Gender | Female
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Dates
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Enumeration Date | 07/02/2015
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Last Update Date | 12/06/2021
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Provider Practice Location Address
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Address Line | 2700 14TH AVE SE
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City | ALBANY
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State | OR
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Zip | 97322-6956
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Country | US
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Telephone | 541-928-1666
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Fax |
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Provider Business Mailing Address
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Address Line | 3029 MOUNTAIN VIEW DR
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City | LAGUNA BEACH
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State | CA
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Zip | 92651-2022
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Country | US
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Telephone | 949-637-3543
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 15288
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License Number State | CA
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