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General NPI Number Information
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NPI Number | 1609964949
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Entity Type | Organization
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Legal Business Name | MASK, INC.
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 04/22/2008
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Provider Practice Location Address
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Address Line | 12737 GLENOAKS BLVD STE 27
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City | SYLMAR
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State | CA
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Zip | 91342-4777
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Country | US
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Telephone | 818-362-6894
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Fax | 818-362-6896
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Provider Business Mailing Address
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Address Line | 12737 GLENOAKS BLVD
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City | SYLMAR
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State | CA
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Zip | 91342-4704
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Country | US
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Telephone | 818-362-6894
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Fax | 818-362-6896
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Authorized Official
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Title or Position | PHARM. D./ PRESIDENT
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Name | DR. MUSUMI IWANAGA
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Credential | RPH.
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Telephone | 818-362-6894
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY43627
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License Number State | CA
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