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General NPI Number Information
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NPI Number | 1346644887
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Entity Type | Individual
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Provider Name | MARK ALLEN STEIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/13/2014
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Last Update Date | 10/13/2014
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Provider Practice Location Address
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Address Line | 1414 WILSHIRE BLVD ACOLOGY
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City | SANTA MONICA
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State | CA
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Zip | 90403
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Country | US
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Telephone | 310-828-9640
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Fax | 206-202-5620
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Provider Business Mailing Address
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Address Line | 934 19TH STREET SUITE 1
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City | SAMTA MONICA
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State | CA
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Zip | 90403
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Country | US
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Telephone | 310-828-9640
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Fax | 206-202-5620
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A23799
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License Number State | CA
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