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General NPI Number Information
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NPI Number | 1407808454
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Entity Type | Individual
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Provider Name | NEERAJ J. PANCHAL M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 09/19/2007
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Provider Practice Location Address
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Address Line | 8745 AERO DR SUITE 200
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City | SAN DIEGO
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State | CA
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Zip | 92123-1761
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Country | US
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Telephone | 858-565-0950
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Fax | 858-565-2863
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Provider Business Mailing Address
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Address Line | PO BOX 23540
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City | SAN DIEGO
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State | CA
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Zip | 92193-3540
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Country | US
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Telephone | 858-565-0950
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Fax | 858-565-2863
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A83142
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License Number State | CA
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