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General NPI Number Information
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NPI Number | 1366084535
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Entity Type | Individual
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Provider Name | LUO XU
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Gender | Female
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Dates
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Enumeration Date | 10/09/2019
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Last Update Date | 10/09/2019
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Provider Practice Location Address
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Address Line | 757 WESTWOOD PLZ # 2146
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City | LOS ANGELES
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State | CA
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Zip | 90095-8358
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Country | US
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Telephone | 310-267-9793
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Fax |
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Provider Business Mailing Address
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Address Line | 1663 MALCOLM AVE APT 101
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City | LOS ANGELES
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State | CA
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Zip | 90024-6836
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Country | US
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Telephone | 949-836-5309
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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 | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 95012460
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License Number State | CA
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