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General NPI Number Information
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NPI Number | 1356761431
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Entity Type | Organization
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Legal Business Name | NANU MEDICAL CORP
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Dates
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Enumeration Date | 04/16/2014
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Last Update Date | 04/16/2014
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Provider Practice Location Address
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Address Line | 22 ODYSSEY STE 240
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City | IRVINE
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State | CA
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Zip | 92618-7700
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Country | US
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Telephone | 949-207-3797
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Fax | 949-207-3799
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Provider Business Mailing Address
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Address Line | 40 PASO ROBLES
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City | IRVINE
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State | CA
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Zip | 92602-1091
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Country | US
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Telephone | 312-420-2478
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND OWNER
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Name | DR. RAVINDRA R CHAND
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Credential | M.D.
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Telephone | 312-420-2478
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | C52842
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License Number State | CA
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