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General NPI Number Information
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NPI Number | 1558595967
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Entity Type | Individual
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Provider Name | RAY ZHAO D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/13/2009
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Last Update Date | 12/02/2021
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Provider Practice Location Address
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Address Line | 1350 W COVINA BLVD
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City | SAN DIMAS
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State | CA
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Zip | 91773-3245
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Country | US
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Telephone | 626-872-3457
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 916
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City | TEMPLE CITY
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State | CA
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Zip | 91780-0916
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Country | US
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Telephone | 626-872-3457
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 20A10792
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License Number State | CA
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