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General NPI Number Information
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NPI Number | 1447370804
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Entity Type | Organization
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Legal Business Name | ALLERGY & ASTHMA MEDICAL CLINIC,INC
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 10/01/2008
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Provider Practice Location Address
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Address Line | 750 W OLIVE AVE STE 103
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City | MERCED
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State | CA
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Zip | 95348-2436
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Country | US
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Telephone | 209-383-6868
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Fax | 209-383-0760
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Provider Business Mailing Address
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Address Line | 750 W OLIVE AVE STE 103
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City | MERCED
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State | CA
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Zip | 95348-2436
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Country | US
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Telephone | 209-383-6868
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Fax | 209-383-0760
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Authorized Official
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Title or Position | M.D.
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Name | DR. MOHAN P. REDDY
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Credential | M.D.
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Telephone | 209-383-6868
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | A262450
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License Number State | CA
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