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General NPI Number Information
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NPI Number | 1306079181
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Entity Type | Organization
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Legal Business Name | REYNALDO L. MAKABALI MD, INC.
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Dates
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Enumeration Date | 08/27/2009
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Last Update Date | 05/22/2019
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Provider Practice Location Address
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Address Line | 2426 W 8TH ST STE 104
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City | LOS ANGELES
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State | CA
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Zip | 90057-3840
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Country | US
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Telephone | 213-389-9595
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Fax | 213-389-2556
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Provider Business Mailing Address
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Address Line | 2426 W 8TH ST STE 104
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City | LOS ANGELES
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State | CA
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Zip | 90057-3840
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Country | US
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Telephone | 213-389-9595
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Fax | 213-389-2556
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. REYNALDO LIMPIN MAKABALI
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Credential | MD
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Telephone | 213-389-9595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A51157
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A51157
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License Number State | CA
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