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General NPI Number Information
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NPI Number | 1427589043
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Entity Type | Individual
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Provider Name | SHIVANI REDDY M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/24/2017
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Last Update Date | 05/03/2022
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Provider Practice Location Address
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Address Line | 525 SOUTH DR STE 115
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-4211
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Country | US
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Telephone | 650-969-5600
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Fax | 650-969-0360
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Provider Business Mailing Address
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Address Line | 6399 SAN IGNACIO AVE STE 120
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City | SAN JOSE
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State | CA
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Zip | 95119-1215
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Country | US
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Telephone |
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Fax | 408-904-7730
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | A162084
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License Number State | CA
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