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NPI 1598709867

NPI 1598709867 : STEVE SLAVA OBEREMOK MD : HEMET, CA

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General NPI Number Information
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    NPI Number           |    1598709867
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    Entity Type          |    Individual 
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    Provider Name        |    STEVE SLAVA OBEREMOK MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/16/2006
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    Last Update Date     |    08/19/2010
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Provider Practice Location Address
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    Address Line         |    720 E LATHAM AVE SUITE 1
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    City                 |    HEMET
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    State                |    CA
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    Zip                  |    92543-4371
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    Country              |    US
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    Telephone            |    951-658-9461
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    Fax                  |    951-652-7103
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Provider Business Mailing Address
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    Address Line         |    720 E LATHAM AVE SUITE 1
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    City                 |    HEMET
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    State                |    CA
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    Zip                  |    92543-4371
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    Country              |    US
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    Telephone            |    951-658-9461
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    Fax                  |    951-652-7103
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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        |    207N00000X
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    Taxonomy Name        |    Dermatology Physician
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    License Number       |    A86584
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    License Number State |    CA
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Taxonomy #2
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    Taxonomy Code        |    207ND0101X
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    Taxonomy Name        |    MOHS-Micrographic Surgery Physician
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    License Number       |    A86584
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    License Number State |    CA
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