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General NPI Number Information
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NPI Number | 1417218124
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Entity Type | Organization
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Legal Business Name | RIVERSIDE RADIATION ONCOLOGY MEDICAL GROUP
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Dates
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Enumeration Date | 05/30/2012
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Last Update Date | 05/30/2012
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Provider Practice Location Address
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Address Line | 4500 BROCKTON AVE 101
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City | RIVERSIDE
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State | CA
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Zip | 92501-4090
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Country | US
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Telephone | 951-788-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 2650 ELM AVE 201
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City | LONG BEACH
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State | CA
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Zip | 90806-1651
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Country | US
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Telephone | 562-492-6695
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Fax | 562-988-0389
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. ALAM SYED
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Credential | MD
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Telephone | 562-492-6695
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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