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General NPI Number Information
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NPI Number | 1386794741
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Entity Type | Individual
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Provider Name | KAMAKSHI DEVARAJAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3630 E IMPERIAL HWY
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City | LYNWOOD
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State | CA
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Zip | 90262-2609
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Country | US
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Telephone | 310-900-2005
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Fax |
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Provider Business Mailing Address
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Address Line | 90 HEADLAND DR
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City | RANCHO PALOS VERDES
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State | CA
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Zip | 90275-5117
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Country | US
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Telephone | 310-833-0082
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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 | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | A55865
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License Number State | CA
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