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General NPI Number Information
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NPI Number | 1407835119
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Entity Type | Individual
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Provider Name | SHI-QI WU M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4650 W SUNSET BLVD MS# 43
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City | LOS ANGELES
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State | CA
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Zip | 90027-6062
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Country | US
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Telephone | 323-671-7658
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Fax | 323-671-3647
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Provider Business Mailing Address
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Address Line | 2317 BRANDEN ST
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City | LOS ANGELES
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State | CA
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Zip | 90026-1479
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Country | US
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Telephone | 323-662-4481
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Fax | 323-662-4481
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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 | 207SC0300X
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Taxonomy Name | Clinical Cytogenetics Physician
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License Number | DRM023
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License Number State | CA
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