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General NPI Number Information
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NPI Number | 1477608552
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Entity Type | Individual
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Provider Name | SEIFOLAH ESFANDIARI M.D., F.A.C.O.G.
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Gender | Male
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 09/14/2021
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Provider Practice Location Address
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Address Line | 999 N TUSTIN AVE STE 111
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City | SANTA ANA
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State | CA
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Zip | 92705-6504
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Country | US
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Telephone | 714-953-1112
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Fax | 714-547-5792
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Provider Business Mailing Address
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Address Line | 999 N TUSTIN AVE STE 111
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City | SANTA ANA
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State | CA
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Zip | 92705-6504
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Country | US
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Telephone | 714-953-1112
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Fax | 714-547-5792
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | C39653
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License Number State | CA
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