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General NPI Number Information
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NPI Number | 1336999333
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Entity Type | Individual
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Provider Name | ANGELICA LOUISE RAYMUNDO
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Gender | Female
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Dates
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Enumeration Date | 03/25/2024
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 170 E FOOTHILL BLVD
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City | ARCADIA
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State | CA
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Zip | 91006-7427
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Country | US
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Telephone | 626-359-4595
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Fax |
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Provider Business Mailing Address
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Address Line | 707 PARNASSUS AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-2210
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Country | US
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Telephone |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DDS112121
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License Number State | CA
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