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General NPI Number Information
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NPI Number | 1669825667
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Entity Type | Individual
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Provider Name | ANITA KOO O.D.
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Gender | Female
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Dates
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Enumeration Date | 07/14/2016
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 1520 E PLAZA BLVD
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City | NATIONAL CITY
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State | CA
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Zip | 91950-3616
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Country | US
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Telephone | 619-425-7755
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Fax | 619-425-2138
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Provider Business Mailing Address
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Address Line | 555 BIERNACKI CT
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City | CHULA VISTA
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State | CA
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Zip | 91911-6702
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Country | US
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Telephone |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 33430
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License Number State | CA
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