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General NPI Number Information
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NPI Number | 1659546893
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Entity Type | Individual
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Provider Name | SAQIB ANSARI MD
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Gender | Male
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Dates
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Enumeration Date | 04/29/2008
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Last Update Date | 01/02/2015
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Provider Practice Location Address
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Address Line | 815 BAY AVE
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City | CAPITOLA
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State | CA
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Zip | 95010-2186
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Country | US
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Telephone | 831-460-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 2350 W EL CAMINO REAL CREDENTIALING DEPT, 2ND FLOOR
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-6201
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Country | US
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Telephone | 831-460-7300
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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 | 207QS1201X
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Taxonomy Name | Sleep Medicine (Family Medicine) Physician
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License Number | A113196
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License Number State | CA
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