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General NPI Number Information
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NPI Number | 1588700645
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Entity Type | Individual
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Provider Name | EDWARD DELEONARDIS MD
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Gender | Male
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 08/14/2013
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Provider Practice Location Address
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Address Line | 345 S HALCYON RD
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City | ARROYO GRANDE
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State | CA
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Zip | 93420-3896
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Country | US
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Telephone | 805-489-4261
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1507
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City | TEMPLETON
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State | CA
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Zip | 93465-1507
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Country | US
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Telephone | 805-434-4989
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Fax | 805-286-3820
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | G44950
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License Number State | CA
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