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General NPI Number Information
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NPI Number | 1295061786
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Entity Type | Individual
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Provider Name | SARVENAZ SAADAT MOBASSER M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/19/2009
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Last Update Date | 09/11/2012
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Provider Practice Location Address
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Address Line | 204 E PICO BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90015-2508
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Country | US
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Telephone | 213-457-4000
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Fax | 206-984-9849
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Provider Business Mailing Address
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Address Line | PO BOX 299
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City | BEVERLY HILLS
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State | CA
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Zip | 90213-0299
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Country | US
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Telephone | 310-963-2680
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Fax | 206-984-9849
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A104717
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License Number State | CA
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