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General NPI Number Information
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NPI Number | 1295981512
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Entity Type | Individual
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Provider Name | JASON LOUIS ROBY D.O.
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Gender | Male
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Dates
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Enumeration Date | 08/18/2008
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Last Update Date | 10/13/2021
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Provider Practice Location Address
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Address Line | PARADISE VALLEY HOSPITAL 2400 E. 4TH ST.
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City | NATIONAL CITY
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State | CA
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Zip | 91950
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Country | US
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Telephone | 616-470-4158
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Fax |
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Provider Business Mailing Address
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Address Line | 1050 ISLAND AVE UNIT 615
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City | SAN DIEGO
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State | CA
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Zip | 92101-7264
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Country | US
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Telephone | 858-761-3576
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 5101021857
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License Number State | MI
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