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General NPI Number Information
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NPI Number | 1447640149
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Entity Type | Organization
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Legal Business Name | MASSOUD AMINI, M.D. INC.
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Dates
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Enumeration Date | 02/02/2015
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Last Update Date | 02/04/2015
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Provider Practice Location Address
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Address Line | 7143 SEVILLE AVE
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255-4905
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Country | US
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Telephone | 323-587-0145
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Fax | 323-587-6591
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Provider Business Mailing Address
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Address Line | 13459 LIBERTY WAY
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City | WESTMINSTER
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State | CA
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Zip | 92683-2686
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Country | US
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Telephone | 714-642-6166
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MASSOUD S AMINI
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Credential | M.D.
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Telephone | 323-587-0145
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 95001498
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License Number State | CA
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