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General NPI Number Information
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NPI Number | 1477067379
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Entity Type | Individual
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Provider Name | JAMEELA LAVANGIA
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Gender | Female
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Dates
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Enumeration Date | 11/30/2017
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Last Update Date | 11/30/2017
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Provider Practice Location Address
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Address Line | 5310 FOUNTAIN AVE REHAB DEPT
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City | LOS ANGELES
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State | CA
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Zip | 90029-1005
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Country | US
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Telephone | 310-227-1483
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Fax |
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Provider Business Mailing Address
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Address Line | 1729 E PINE AVE APT 3
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City | EL SEGUNDO
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State | CA
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Zip | 90245-4456
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 11525
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License Number State | CA
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