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NPI 1356613582

NPI 1356613582 : ALICIA C DALY RDHAP : LA JOLLA, CA

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General NPI Number Information
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    NPI Number           |    1356613582
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    Entity Type          |    Individual 
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    Provider Name        |    ALICIA C DALY RDHAP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/03/2012
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    Last Update Date     |    06/28/2014
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Provider Practice Location Address
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    Address Line         |    5580 LA JOLLA BLVD. #144 
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    City                 |    LA JOLLA
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    State                |    CA
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    Zip                  |    92037
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    Country              |    US
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    Telephone            |    714-461-8050
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    5580 LA JOLLA BLVD. #144 
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    City                 |    LA JOLLA
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    State                |    CA
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    Zip                  |    92037
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    Country              |    US
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    Telephone            |    714-461-8050
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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        |    124Q00000X
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    Taxonomy Name        |    Dental Hygienist
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    License Number       |    HAP349
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    License Number State |    CA
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