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General NPI Number Information
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NPI Number | 1639583453
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Entity Type | Individual
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Provider Name | CONNIE Y MUN-PRICE D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/19/2014
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Last Update Date | 09/05/2019
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Provider Practice Location Address
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Address Line | 4650 W SUNSET BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90027-6062
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Country | US
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Telephone | 323-660-2450
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Fax |
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Provider Business Mailing Address
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Address Line | 26520 CACTUS AVE DEPARTMENT OF ANESTHESIA
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City | MORENO VALLEY
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State | CA
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Zip | 92555
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Country | US
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Telephone | 951-486-4574
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207LP3000X
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Taxonomy Name | Pediatric Anesthesiology Physician
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License Number | 20A14462
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License Number State | CA
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