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General NPI Number Information
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NPI Number | 1649241837
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Entity Type | Individual
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Provider Name | SHAYLA FOWLER KASEL M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/27/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1070 COUNTRY CLUB DR. WEST SUITE C
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City | SIMI VALLEY
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State | CA
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Zip | 93065
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Country | US
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Telephone | 805-306-0222
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Fax | 805-583-2048
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Provider Business Mailing Address
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Address Line | 1070 COUNTRY CLUB DR. WEST SUITE C
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City | SIMI VALLEY
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State | CA
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Zip | 93065
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Country | US
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Telephone | 805-306-0222
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Fax | 805-583-2048
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G78249
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License Number State | CA
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