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General NPI Number Information
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NPI Number | 1306117817
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Entity Type | Organization
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Legal Business Name | THEODORE S. FEIT, M.D., INC.
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Dates
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Enumeration Date | 01/16/2012
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Last Update Date | 01/16/2012
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Provider Practice Location Address
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Address Line | 2601 W ALAMEDA AVE SUITE 310
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City | BURBANK
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State | CA
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Zip | 91505-4800
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Country | US
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Telephone | 818-636-6463
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Fax | 818-345-3533
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Provider Business Mailing Address
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Address Line | 2601 W ALAMEDA AVE SUITE 310
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City | BURBANK
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State | CA
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Zip | 91505-4800
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Country | US
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Telephone | 818-636-6463
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Fax | 818-345-3533
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | THEODORE STUART FEIT
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Credential | M.D.
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Telephone | 818-636-6463
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | G32804
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License Number State | CA
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