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General NPI Number Information
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NPI Number | 1508179706
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Entity Type | Individual
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Provider Name | EMMANUEL DELA CRUZ II O.D.
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Gender | Male
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Dates
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Enumeration Date | 07/16/2010
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Last Update Date | 09/03/2019
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Provider Practice Location Address
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Address Line | 1898 W EL CAMINO REAL
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-2356
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Country | US
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Telephone | 650-961-2926
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Fax | 650-961-2890
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Provider Business Mailing Address
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Address Line | 43955 S MORAY ST
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City | FREMONT
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State | CA
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Zip | 94539-5942
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Country | US
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Telephone | 408-360-9312
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 13964
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License Number State | CA
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