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General NPI Number Information
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NPI Number | 1427456151
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Entity Type | Individual
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Provider Name | SIAVOSH VAKILIAN MD
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Gender | Male
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Dates
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Enumeration Date | 12/11/2014
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Last Update Date | 06/01/2021
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Provider Practice Location Address
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Address Line | 3366 5TH AVE
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City | SAN DIEGO
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State | CA
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Zip | 92103-5713
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Country | US
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Telephone | 619-230-0400
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Fax | 858-429-7936
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Provider Business Mailing Address
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Address Line | PO BOX 845996
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City | LOS ANGELES
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State | CA
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Zip | 90084-3592
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Country | US
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Telephone | 858-888-7700
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Fax | 858-221-5036
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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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | A133482
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License Number State | CA
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