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General NPI Number Information
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NPI Number | 1710702014
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Entity Type | Organization
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Legal Business Name | KATHMED
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Dates
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Enumeration Date | 11/21/2024
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 2382 FARADAY AVE STE 200-25
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City | CARLSBAD
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State | CA
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Zip | 92008-7218
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Country | US
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Telephone | 760-295-8069
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Fax |
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Provider Business Mailing Address
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Address Line | 310 S TWIN OAKS VALLEY RD # 107-229
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City | SAN MARCOS
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State | CA
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Zip | 92078-4303
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Country | US
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Telephone | 818-645-6366
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | TWEE HYLER
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Credential |
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Telephone | 818-645-6636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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