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General NPI Number Information
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NPI Number | 1376763565
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Entity Type | Individual
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Provider Name | LAILA SHIRAZ MALAD M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/27/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 31225 LA BAYA DR SUITE 205
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91362-4019
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Country | US
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Telephone | 818-865-8190
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Fax | 818-735-9445
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Provider Business Mailing Address
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Address Line | 31225 LA BAYA DRIVE, SUITE 205
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91362-6325
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Country | US
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Telephone | 818-865-8190
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Fax | 818-735-9445
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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 | 2084D0003X
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Taxonomy Name | Diagnostic Neuroimaging (Psychiatry & Neurology) Physician
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License Number | A34464
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License Number State | CA
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