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General NPI Number Information
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NPI Number | 1588097745
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Entity Type | Organization
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Legal Business Name | KOHANIM CHIROPRACTIC INC
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Dates
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Enumeration Date | 08/12/2013
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Last Update Date | 08/12/2013
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Provider Practice Location Address
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Address Line | 3540 WILSHIRE BLVD STE 501
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City | LOS ANGELES
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State | CA
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Zip | 90010-2349
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Country | US
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Telephone | 213-480-3191
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Fax | 213-480-3188
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Provider Business Mailing Address
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Address Line | 3540 WILSHIRE BLVD STE 501
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City | LOS ANGELES
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State | CA
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Zip | 90010-2349
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Country | US
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Telephone | 213-480-3191
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Fax | 213-480-3188
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Authorized Official
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Title or Position | OWNER
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Name | RENEE KOHANIM
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Credential |
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Telephone | 213-480-3191
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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 | DC27469
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License Number State | CA
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