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General NPI Number Information
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NPI Number | 1548650732
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Entity Type | Organization
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Legal Business Name | ONE WEST MEDICAL GROUP, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 01/27/2015
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Last Update Date | 01/19/2017
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Provider Practice Location Address
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Address Line | 14860 ROSCOE BLVD STE 200
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City | PANORAMA CITY
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State | CA
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Zip | 91402-4683
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Country | US
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Telephone | 310-553-5203
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Fax | 310-652-0933
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Provider Business Mailing Address
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Address Line | PO BOX 894874
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City | LOS ANGELES
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State | CA
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Zip | 90189-4874
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Country | US
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Telephone | 310-553-5203
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Fax | 310-652-0933
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Authorized Official
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Title or Position | MANAGER
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Name | DR. ASHLEY ALFRED WOOL-SMITH
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Credential | DC
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Telephone | 310-553-5203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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