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General NPI Number Information
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NPI Number | 1396922647
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Entity Type | Organization
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Legal Business Name | HALEY & LEE INC
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Dates
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Enumeration Date | 01/29/2008
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Last Update Date | 08/08/2012
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Provider Practice Location Address
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Address Line | 4361 S WESTERN AVE
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City | LOS ANGELES
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State | CA
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Zip | 90062-1651
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Country | US
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Telephone | 323-295-5446
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Fax | 323-295-2117
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Provider Business Mailing Address
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Address Line | 4361 S WESTERN AVE
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City | LOS ANGELES
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State | CA
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Zip | 90062-1651
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Country | US
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Telephone | 323-295-5446
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Fax | 323-295-2117
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Authorized Official
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Title or Position | OWNER
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Name | CLIFTON V LEE
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Credential | MD
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Telephone | 323-295-5446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | C25282
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License Number State | CA
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