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NPI 1316024565

NPI 1316024565 : VERDUGO MEDICAL GROUP, INC. : SUN VALLEY, CA

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General NPI Number Information
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    NPI Number           |    1316024565
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    Entity Type          |    Organization 
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    Legal Business Name  |    VERDUGO MEDICAL GROUP, INC. 
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Dates
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    Enumeration Date     |    11/01/2006
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    Last Update Date     |    08/22/2020
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Provider Practice Location Address
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    Address Line         |    8741 LAUREL CANYON BLVD 
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    City                 |    SUN VALLEY
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    State                |    CA
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    Zip                  |    91352-2919
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    Country              |    US
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    Telephone            |    818-767-7640
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    Fax                  |    818-954-0029
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Provider Business Mailing Address
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    Address Line         |    8741 LAUREL CANYON BLVD 
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    City                 |    SUN VALLEY
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    State                |    CA
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    Zip                  |    91352-2919
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    Country              |    US
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    Telephone            |    818-767-7640
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    Fax                  |    818-954-0029
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Authorized Official
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    Title or Position    |    PRESIDENT/OWNER
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    Name                 |    DR. MEHMET  KASIM 
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    Credential           |    M.D.
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    Telephone            |    818-438-6295
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207V00000X
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    Taxonomy Name        |    Obstetrics & Gynecology Physician
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    License Number       |    00A334650
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    License Number State |    CA
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Taxonomy #2
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    Taxonomy Code        |    207V00000X
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    Taxonomy Name        |    Obstetrics & Gynecology Physician
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    License Number       |    A31823
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    License Number State |    CA
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