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General NPI Number Information
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NPI Number | 1649853722
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Entity Type | Individual
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Provider Name | RAYMOND JOHN LYNCH RN
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Gender | Male
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Dates
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Enumeration Date | 05/05/2021
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Last Update Date | 05/05/2021
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Provider Practice Location Address
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Address Line | 1115 S SUNSET AVE
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City | WEST COVINA
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State | CA
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Zip | 91790-3940
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Country | US
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Telephone | 626-814-2534
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Fax | 626-814-2591
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Provider Business Mailing Address
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Address Line | 9615 FOXBURY WAY
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City | PICO RIVERA
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State | CA
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Zip | 90660-3933
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Country | US
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Telephone | 323-718-0290
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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 | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 852165
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License Number State | CA
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