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General NPI Number Information
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NPI Number | 1346235546
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Entity Type | Individual
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Provider Name | STEVEN POULOS D. C.
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Gender | Male
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Dates
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Enumeration Date | 09/13/2005
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Last Update Date | 12/31/2009
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Provider Practice Location Address
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Address Line | 26072 MERIT CIR SUITE 119
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-7015
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Country | US
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Telephone | 949-707-4556
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Fax | 949-859-6606
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Provider Business Mailing Address
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Address Line | PO BOX 80356
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City | RANCHO SANTA MARGARITA
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State | CA
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Zip | 92688-0356
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Country | US
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Telephone | 949-707-4556
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Fax | 949-859-6606
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC24562
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License Number State | CA
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