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General NPI Number Information
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NPI Number | 1386132744
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Entity Type | Organization
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Legal Business Name | MASKET FOUNDATION CLINIC FOR EYE CARE
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Dates
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Enumeration Date | 05/01/2018
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Last Update Date | 05/01/2018
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Provider Practice Location Address
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Address Line | 2080 CENTURY PARK E STE 911
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City | LOS ANGELES
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State | CA
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Zip | 90067-2012
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Country | US
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Telephone | 626-840-6683
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2029
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City | BAKERSFIELD
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State | CA
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Zip | 93303-2029
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Country | US
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Telephone | 661-843-7616
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Fax | 661-748-1773
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Authorized Official
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Title or Position | PRESIDENT
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Name | SAMUEL MASKET
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Credential | MD
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Telephone | 310-562-3271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State | CA
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