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General NPI Number Information
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NPI Number | 1699400101
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Entity Type | Individual
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Provider Name | MAHMUOD ABDELJABER MD, PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/19/2022
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Last Update Date | 09/28/2024
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Provider Practice Location Address
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Address Line | 757 WESTWOOD PLZ
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City | LOS ANGELES
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State | CA
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Zip | 90095-1282
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Country | US
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Telephone | 310-825-9111
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Fax |
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Provider Business Mailing Address
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Address Line | 10833 LE CONTE AVE # AS-302C
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City | LOS ANGELES
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State | CA
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Zip | 90095-3075
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Country | US
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Telephone | 310-948-8891
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | A198325
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License Number State | CA
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