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General NPI Number Information
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NPI Number | 1659545069
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Entity Type | Organization
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Legal Business Name | MONES JOHN MOHSENI AND MINA MOHSENI
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Dates
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Enumeration Date | 04/16/2008
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 19834 HATHAWAY AVE
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City | HAYWARD
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State | CA
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Zip | 94541-2313
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Country | US
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Telephone | 510-278-8908
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Fax | 510-278-8908
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Provider Business Mailing Address
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Address Line | 19834 HATHAWAY AVE
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City | HAYWARD
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State | CA
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Zip | 94541-2313
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Country | US
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Telephone | 510-278-8908
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Fax | 510-278-8908
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Authorized Official
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Title or Position | LICENSEE/ADMINISTRATOR
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Name | MR. MONES JOHN MOHSENI
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Credential |
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Telephone | 510-278-8908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number | 550000119
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License Number State | CA
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