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General NPI Number Information
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NPI Number | 1689024887
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Entity Type | Organization
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Legal Business Name | KEITH G TOKUHARA MD INC
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Dates
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Enumeration Date | 06/17/2016
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Last Update Date | 12/09/2020
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Provider Practice Location Address
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Address Line | 35900 BOB HOPE DR STE 175
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-1767
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Country | US
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Telephone | 760-340-4700
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Fax | 760-568-2490
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Provider Business Mailing Address
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Address Line | 35900 BOB HOPE DR STE 175
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-1767
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Country | US
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Telephone | 760-340-4700
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Fax | 760-568-2490
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | REBECCA TOKUHARA
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Credential |
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Telephone | 760-340-4700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | A97863
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License Number State | CA
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