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General NPI Number Information
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NPI Number | 1295134286
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Entity Type | Individual
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Provider Name | ELAD MOISSEIEV MD
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Gender | Male
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Dates
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Enumeration Date | 08/15/2014
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Last Update Date | 08/15/2014
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Provider Practice Location Address
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Address Line | 4860 Y ST STE 2400
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City | SACRAMENTO
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State | CA
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Zip | 95817-2307
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Country | US
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Telephone | 916-215-0879
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Fax |
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Provider Business Mailing Address
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Address Line | 2225 GLACIER DR APT 70
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City | DAVIS
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State | CA
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Zip | 95616-7321
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Country | US
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Telephone | 530-304-4127
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | F316
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License Number State | CA
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