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General NPI Number Information
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NPI Number | 1386667780
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Entity Type | Individual
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Provider Name | ANIBAL RAUL GAUTO M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 02/25/2016
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Provider Practice Location Address
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Address Line | 39300 BOB HOPE DR BANNAN BLDG. 1109
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-3203
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Country | US
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Telephone | 760-834-3790
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Fax | 760-834-3791
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Provider Business Mailing Address
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Address Line | 39300 BOB HOPE DR BANNAN BLDG 1109
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-3203
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Country | US
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Telephone | 760-834-3790
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Fax | 760-834-3791
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 00A367340
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | A36734
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License Number State | CA
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