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General NPI Number Information
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NPI Number | 1346395605
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Entity Type | Organization
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Legal Business Name | MICHEL J. MAZOUZ, M.D., A MEDICAL CORPORATION
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 07/14/2015
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Provider Practice Location Address
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Address Line | 1125 S BEVERLY DR SUITE 730
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City | LOS ANGELES
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State | CA
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Zip | 90035-1148
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Country | US
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Telephone | 310-201-0626
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Fax | 310-277-2852
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Provider Business Mailing Address
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Address Line | PO BOX 67218
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City | LOS ANGELES
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State | CA
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Zip | 90067-0218
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Country | US
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Telephone | 310-201-0626
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHEL J. MAZOUZ
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Credential | M.D.
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Telephone | 310-201-0626
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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 | A44045
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License Number State | CA
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