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General NPI Number Information
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NPI Number | 1669450490
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Entity Type | Individual
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Provider Name | KRISTEN JEAN MACLEOD MD
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Gender | Female
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Dates
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Enumeration Date | 01/03/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 3300 STOCKTON BLVD UC DAVIS MEDICAL CTR CAARE CENTER
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City | SACRAMENTO
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State | CA
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Zip | 95820-1451
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Country | US
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Telephone | 916-735-8399
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Fax |
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Provider Business Mailing Address
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Address Line | 4530 MOUNTAINGATE DR
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City | RENO
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State | NV
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Zip | 89509-7942
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Country | US
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Telephone | 775-746-9878
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A073942
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License Number State | CA
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