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General NPI Number Information
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NPI Number | 1639106198
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Entity Type | Individual
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Provider Name | MUKESHCHANDRA M PATEL M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 08/07/2015
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Provider Practice Location Address
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Address Line | 16018 TUSCOLA RD 9
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City | APPLE VALLEY
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State | CA
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Zip | 92307-1329
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Country | US
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Telephone | 760-946-1344
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Fax | 760-946-2477
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Provider Business Mailing Address
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Address Line | P O BOX 1030
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City | VICTORVILLE
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State | CA
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Zip | 92393-1030
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Country | US
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Telephone | 760-946-1344
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Fax | 760-946-2477
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | A43158
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License Number State | CA
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