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General NPI Number Information
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NPI Number | 1366450116
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Entity Type | Individual
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Provider Name | MAURICE J HALE MD
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Gender | Male
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 09/22/2020
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Provider Practice Location Address
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Address Line | 800 S CENTRAL AVE SUITE 100B
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City | GLENDALE
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State | CA
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Zip | 91204-4370
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Country | US
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Telephone | 818-548-8333
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Fax | 818-548-7888
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Provider Business Mailing Address
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Address Line | 4910 VAN NUYS BLVD STE 108
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-1757
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Country | US
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Telephone | 818-548-8333
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Fax | 818-548-7888
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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 | G84687
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License Number State | CA
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