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General NPI Number Information
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NPI Number | 1386963361
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Entity Type | Individual
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Provider Name | KUO-HUNG JOHN YU D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 05/31/2010
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Last Update Date | 08/28/2013
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Provider Practice Location Address
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Address Line | 416 W LAS TUNAS DR SUITE 203
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City | SAN GABRIEL
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State | CA
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Zip | 91776-1236
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Country | US
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Telephone | 626-789-2545
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Fax |
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Provider Business Mailing Address
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Address Line | 18 ENDEAVOR SUITE 106
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City | IRVINE
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State | CA
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Zip | 92618-3164
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Country | US
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Telephone | 323-639-0275
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 57248
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License Number State | CA
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