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General NPI Number Information
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NPI Number | 1437763224
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Entity Type | Organization
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Legal Business Name | MOLA MEDICAL PRACTICE INC
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Dates
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Enumeration Date | 08/31/2020
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 415 N CRESCENT DR STE 300
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-6814
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Country | US
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Telephone | 310-657-9191
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Fax |
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Provider Business Mailing Address
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Address Line | 415 N CRESCENT DR STE 300
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-6814
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Country | US
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Telephone | 310-657-9191
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Fax |
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Authorized Official
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Title or Position | BILLING SUPERVISOR
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Name | ARIEL WEEKS
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Credential |
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Telephone | 818-921-4127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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