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NPI 1649526708

NPI 1649526708 : DAVID ABRAHAM KAMINKER LAC, MSOM : ASHLAND, OR

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General NPI Number Information
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    NPI Number           |    1649526708
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    Entity Type          |    Individual 
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    Provider Name        |    DAVID ABRAHAM KAMINKER LAC, MSOM
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/26/2012
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    Last Update Date     |    07/26/2012
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Provider Practice Location Address
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    Address Line         |    1012 E MAIN ST 
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    City                 |    ASHLAND
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    State                |    OR
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    Zip                  |    97520-2123
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    Country              |    US
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    Telephone            |    541-708-0642
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1012 E MAIN ST 
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    City                 |    ASHLAND
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    State                |    OR
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    Zip                  |    97520-2123
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    Country              |    US
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    Telephone            |    541-708-0642
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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        |    171100000X
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    Taxonomy Name        |    Acupuncturist
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    License Number       |    AC157420
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    License Number State |    OR
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