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General NPI Number Information
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NPI Number | 1386004497
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Entity Type | Organization
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Legal Business Name | ANU RAJASEKARAN, DMD.PC.
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Dates
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Enumeration Date | 03/02/2016
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Last Update Date | 10/02/2020
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Provider Practice Location Address
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Address Line | 12630 MONTE VISTA RD STE 103
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City | POWAY
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State | CA
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Zip | 92064-2526
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Country | US
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Telephone | 858-755-7474
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Fax |
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Provider Business Mailing Address
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Address Line | 12068 DAYMARK CT
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City | SAN DIEGO
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State | CA
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Zip | 92131-3801
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Country | US
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Telephone | 858-449-2255
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANU R RAJASEKARAN
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Credential | DMD
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Telephone | 858-755-7474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | CA45313
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License Number State | CA
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