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General NPI Number Information
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NPI Number | 1386174324
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Entity Type | Individual
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Provider Name | AMANDA HEIM SRISATHAPAT LAC
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Gender | Female
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Dates
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Enumeration Date | 06/13/2017
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Last Update Date | 08/31/2021
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Provider Practice Location Address
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Address Line | 10000 FLOWER ST
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City | BELLFLOWER
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State | CA
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Zip | 90706-5413
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Country | US
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Telephone | 562-804-3449
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Fax |
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Provider Business Mailing Address
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Address Line | 18909 FLORWOOD AVE
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City | TORRANCE
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State | CA
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Zip | 90504-5631
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Country | US
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Telephone | 949-274-0344
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 17502
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License Number State | CA
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