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General NPI Number Information
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NPI Number | 1356405732
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Entity Type | Individual
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Provider Name | LINA LEE M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 12021 WILMINGTON AVE
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City | LOS ANGELES
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State | CA
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Zip | 90059-3019
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Country | US
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Telephone | 310-668-4683
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Fax |
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Provider Business Mailing Address
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Address Line | 1835 S SANTA ANITA AVE
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City | ARCADIA
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State | CA
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Zip | 91006-4655
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Country | US
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Telephone | 626-203-8327
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Fax | 626-294-0057
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | A070424
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License Number State | CA
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