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General NPI Number Information
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NPI Number | 1538280169
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Entity Type | Individual
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Provider Name | MICHAEL JOHN CLIFFORD DC
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Gender | Male
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5465 SANTA MONICA BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90029-2339
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Country | US
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Telephone | 323-466-6958
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Fax |
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Provider Business Mailing Address
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Address Line | 7013 FLIGHT AVE
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City | LOS ANGELES
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State | CA
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Zip | 90045-1803
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Country | US
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Telephone | 310-568-0744
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 30299
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License Number State | CA
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