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General NPI Number Information
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NPI Number | 1326073081
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Entity Type | Individual
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Provider Name | KEITH E DAMSKER MD
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Gender | Male
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 11/29/2021
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Provider Practice Location Address
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Address Line | 110 N LA BREA AVE
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City | INGLEWOOD
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State | CA
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Zip | 90301-1708
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Country | US
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Telephone | 310-419-3340
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Fax | 310-419-3411
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Provider Business Mailing Address
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Address Line | 110 N LA BREA AVE
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City | INGLEWOOD
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State | CA
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Zip | 90301-1708
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Country | US
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Telephone | 310-419-3340
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Fax | 310-419-3411
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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 | MD429698
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD60190998
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C54755
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License Number State | CA
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