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General NPI Number Information
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NPI Number | 1629421797
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Entity Type | Organization
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Legal Business Name | RIAZ MEDICAL GROUP INC
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Dates
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Enumeration Date | 07/13/2016
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Last Update Date | 12/19/2016
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Provider Practice Location Address
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Address Line | 1800 SPRING RIDGE DR
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City | SUSANVILLE
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State | CA
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Zip | 96130-6100
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Country | US
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Telephone | 702-453-3799
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Fax | 702-453-5741
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Provider Business Mailing Address
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Address Line | 1921 ANNA AVE
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City | RICHLAND
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State | WA
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Zip | 99352-9521
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Country | US
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Telephone | 702-453-3799
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Fax | 702-453-5741
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Authorized Official
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Title or Position | SOLE OWNER
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Name | MUHAMMAD RIAZ
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Credential | M.D.
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Telephone | 805-704-7910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A127480
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License Number State | CA
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