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NPI 1477989010

NPI 1477989010 : GOPAL D SOJITRA PHARMD : RANCHO CUCAMONGA, CA

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General NPI Number Information
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    NPI Number           |    1477989010
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    Entity Type          |    Individual 
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    Provider Name        |    GOPAL D SOJITRA PHARMD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/14/2013
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    Last Update Date     |    09/14/2013
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Provider Practice Location Address
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    Address Line         |    10400 ARROW RTE APT O-09
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    City                 |    RANCHO CUCAMONGA
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    State                |    CA
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    Zip                  |    91730-4772
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    Country              |    US
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    Telephone            |    862-251-2153
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    10400 ARROW RTE APT O-09
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    City                 |    RANCHO CUCAMONGA
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    State                |    CA
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    Zip                  |    91730-4772
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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        |    183500000X
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    Taxonomy Name        |    Pharmacist
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    License Number       |    69070
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    License Number State |    CA
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