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General NPI Number Information
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NPI Number | 1457447393
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Entity Type | Organization
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Legal Business Name | ANJANETTE HOGAN,MD,INC
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 09/19/2012
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Provider Practice Location Address
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Address Line | 550 W REGENT ST UNIT #319
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City | INGLEWOOD
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State | CA
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Zip | 90301-1080
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Country | US
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Telephone | 310-463-5338
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Fax | 310-532-0889
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Provider Business Mailing Address
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Address Line | 1141 W REDONDO BEACH BLVD #409
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City | GARDENA
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State | CA
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Zip | 90247-3586
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Country | US
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Telephone | 310-532-0308
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Fax | 310-532-0889
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANJANETTE M HOGAN
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Credential | MD
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Telephone | 323-296-0150
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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 | 00021705320019
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License Number State | CA
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