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General NPI Number Information
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NPI Number | 1619188315
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Entity Type | Individual
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Provider Name | ANGE J LOBUE M.D.,M.P.H.,B.S.PH.
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Gender | Male
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 07/12/2007
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Provider Practice Location Address
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Address Line | 525 2ND ST SUITE 300
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City | EUREKA
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State | CA
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Zip | 95501-0437
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Country | US
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Telephone | 707-444-1616
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Fax |
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Provider Business Mailing Address
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Address Line | 525 2ND ST SUITE 300
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City | EUREKA
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State | CA
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Zip | 95501-0437
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Country | US
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Telephone | 707-444-1616
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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 | 2084P0005X
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Taxonomy Name | Neurodevelopmental Disabilities Physician
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License Number | C72176
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | C27176
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License Number State | CA
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