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NPI 1326072612

NPI 1326072612 : KELVIN MAI DO : SANTA ANA, CA

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General NPI Number Information
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    NPI Number           |    1326072612
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    Entity Type          |    Individual 
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    Provider Name        |    KELVIN MAI DO
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/10/2006
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    Last Update Date     |    09/01/2022
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Provider Practice Location Address
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    Address Line         |    1002 N FAIRVIEW ST 
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    City                 |    SANTA ANA
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    State                |    CA
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    Zip                  |    92703-1811
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    Country              |    US
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    Telephone            |    714-332-1069
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2742 DOW AVE 
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    City                 |    TUSTIN
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    State                |    CA
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    Zip                  |    92780-7242
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    Country              |    US
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    Telephone            |    714-665-1600
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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        |    207R00000X
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    Taxonomy Name        |    Internal Medicine Physician
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    License Number       |    20A8944
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    License Number State |    CA
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