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NPI 1659309037

NPI 1659309037 : DAN LI M.D. : NEWBURY PARK, CA

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General NPI Number Information
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    NPI Number           |    1659309037
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    Entity Type          |    Individual 
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    Provider Name        |    DAN LI M.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/28/2006
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    Last Update Date     |    08/12/2009
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Provider Practice Location Address
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    Address Line         |    356 VIA DE LA MESA 
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    City                 |    NEWBURY PARK
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    State                |    CA
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    Zip                  |    91320-6922
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    Country              |    US
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    Telephone            |    805-490-8390
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    356 VIA DE LA MESA 
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    City                 |    NEWBURY PARK
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    State                |    CA
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    Zip                  |    91320-6922
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    Country              |    US
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    Telephone            |    805-490-8390
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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        |    207R00000X
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    Taxonomy Name        |    Internal Medicine Physician
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    License Number       |    A86068
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    License Number State |    CA
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