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General NPI Number Information
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NPI Number | 1649451923
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Entity Type | Organization
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Legal Business Name | ADVANCED PAIN AND REHABILITATION
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Dates
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Enumeration Date | 11/15/2007
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Last Update Date | 03/26/2018
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Provider Practice Location Address
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Address Line | 429 LLEWELLYN AVE
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City | CAMPBELL
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State | CA
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Zip | 95008-1948
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Country | US
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Telephone | 408-364-1616
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 112538
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City | CAMPBELL
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State | CA
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Zip | 95011-2538
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Country | US
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Telephone | 408-364-1616
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. FELICIA RADU
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Credential | M.D.
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Telephone | 408-370-9080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | A81710
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License Number State | CA
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