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General NPI Number Information
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NPI Number | 1649141920
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Entity Type | Individual
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Provider Name | BRIAN PAUL O'NEAL CPED
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Gender | Male
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Dates
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Enumeration Date | 09/17/2025
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 932 W SOUTHERN AVE STE 7
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City | MESA
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State | AZ
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Zip | 85210-4972
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Country | US
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Telephone | 480-461-1940
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Fax | 480-461-3855
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Provider Business Mailing Address
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Address Line | 7127 E JACOB AVE
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City | MESA
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State | AZ
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Zip | 85209-4027
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Country | US
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Telephone |
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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 | 224L00000X
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Taxonomy Name | Pedorthist
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License Number | CPED2705
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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License Number | CPED2705
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 222Z00000X
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Taxonomy Name | Orthotist
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License Number | CPED2705
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License Number State | AZ
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