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General NPI Number Information
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NPI Number | 1447320569
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Entity Type | Organization
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Legal Business Name | MUDIT DABRAL, M.D.
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 1505 SHEPARD DR SUITE 105
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City | SANTA MARIA
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State | CA
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Zip | 93454-7020
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Country | US
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Telephone | 805-928-9770
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Fax | 805-928-6350
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Provider Business Mailing Address
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Address Line | 1505 SHEPARD DR SUITE 105
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City | SANTA MARIA
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State | CA
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Zip | 93454-7020
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Country | US
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Telephone | 805-928-9770
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Fax | 805-928-6350
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Authorized Official
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Title or Position | OWNER
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Name | DR. MUDIT DABRAL
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Credential | M.D.
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Telephone | 805-928-9770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | A40705
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License Number State | CA
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