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General NPI Number Information
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NPI Number | 1457677874
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Entity Type | Organization
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Legal Business Name | STANLEY L. STOCK, M. D., INC.
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Dates
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Enumeration Date | 04/09/2010
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Last Update Date | 04/09/2010
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Provider Practice Location Address
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Address Line | 1428 W 7TH ST STE B
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City | SAN PEDRO
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State | CA
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Zip | 90732-3523
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Country | US
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Telephone | 310-833-5221
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Fax | 310-833-4022
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Provider Business Mailing Address
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Address Line | 1428 W 7TH ST STE B
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City | SAN PEDRO
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State | CA
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Zip | 90732-3523
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Country | US
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Telephone | 310-833-5221
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Fax | 310-833-4022
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STANLEY LOUIS STOCK
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Credential | M. D.
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Telephone | 310-833-5221
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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 | A19519
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License Number State | CA
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