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General NPI Number Information
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NPI Number | 1417045709
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Entity Type | Individual
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Provider Name | ROGER HARVEY HEILMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 550 S VERMONT AVE 704B
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City | LOS ANGELES
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State | CA
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Zip | 90020-1912
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Country | US
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Telephone | 213-739-7309
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Fax | 213-351-2024
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Provider Business Mailing Address
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Address Line | 3535 LOMBARDY RD
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City | PASADENA
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State | CA
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Zip | 91107-5628
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Country | US
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Telephone | 626-793-2302
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Fax | 626-304-1014
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | G16660
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License Number State | CA
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