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General NPI Number Information
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NPI Number | 1447740493
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Entity Type | Organization
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Legal Business Name | VARICOSE RELIEF INC
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Dates
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Enumeration Date | 05/15/2018
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Last Update Date | 05/15/2018
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Provider Practice Location Address
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Address Line | 3130 W OLYMPIC BLVD SUITE 360
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City | LOS ANGELES
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State | CA
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Zip | 90006-2484
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Country | US
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Telephone | 323-733-1004
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Fax | 323-733-1003
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Provider Business Mailing Address
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Address Line | 3130 W OLYMPIC BLVD SUITE 360
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City | LOS ANGELES
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State | CA
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Zip | 90006-2484
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Country | US
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Telephone | 323-733-1004
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Fax | 323-733-1003
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Authorized Official
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Title or Position | M.D./CEO
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Name | MR. HOSSEIN BABAALI
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Credential | M.D.
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Telephone | 310-367-3268
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | G86162
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | G86162
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | G86162
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License Number State | CA
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