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General NPI Number Information
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NPI Number | 1720323264
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Entity Type | Organization
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Legal Business Name | BA PAIN MANAGEMENT
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Dates
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Enumeration Date | 12/11/2012
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Last Update Date | 02/28/2020
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Provider Practice Location Address
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Address Line | 13160 MINDANAO WAY STE 300
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City | MARINA DEL REY
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State | CA
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Zip | 90292-6393
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Country | US
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Telephone | 855-985-7246
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Fax | 855-985-7246
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Provider Business Mailing Address
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Address Line | 5561 VIA PORTORA UNIT B
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City | LAGUNA WOODS
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State | CA
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Zip | 92637-6958
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Country | US
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Telephone | 855-985-7246
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Fax | 855-985-7246
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Authorized Official
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Title or Position | OWNER
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Name | DENNIS YUN
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Credential | MD
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Telephone | 855-985-7246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | A93764
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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