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General NPI Number Information
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NPI Number | 1720162530
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Entity Type | Individual
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Provider Name | PAUL MICHAEL DAWSON PT
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Gender | Male
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 10/18/2012
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Provider Practice Location Address
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Address Line | 11965 VENICE BLVD SUITE 404
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City | LOS ANGELES
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State | CA
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Zip | 90066-3979
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Country | US
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Telephone | 310-566-7677
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Fax | 310-566-7697
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Provider Business Mailing Address
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Address Line | 11965 VENICE BLVD SUITE 404
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City | LOS ANGELES
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State | CA
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Zip | 90066-3979
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Country | US
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Telephone | 310-566-7677
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Fax | 310-566-7697
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 27141
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License Number State | CA
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