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General NPI Number Information
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NPI Number | 1710055595
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Entity Type | Individual
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Provider Name | MANUEL N CONTRERAS M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 10/21/2011
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Provider Practice Location Address
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Address Line | 9238 1/2 VALLEY BLVD
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City | ROSEMEAD
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State | CA
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Zip | 91770-1922
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Country | US
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Telephone | 626-872-6499
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Fax | 626-872-6490
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Provider Business Mailing Address
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Address Line | 2601 ALTAMIRA DR
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City | WEST COVINA
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State | CA
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Zip | 91792-1904
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Country | US
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Telephone | 626-913-4294
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Fax | 626-872-6490
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A-34444
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License Number State | CA
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