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General NPI Number Information
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NPI Number | 1720803679
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Entity Type | Individual
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Provider Name | JONATHAN CLAYTON MONITZ L.AC, MTOM
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Gender | Male
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Dates
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Enumeration Date | 11/16/2024
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Last Update Date | 11/16/2024
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Provider Practice Location Address
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Address Line | 12135 RIVERSIDE DR
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City | VALLEY VILLAGE
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State | CA
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Zip | 91607-3832
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Country | US
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Telephone | 818-674-4748
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Fax |
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Provider Business Mailing Address
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Address Line | 5419 HOLLYWOOD BLVD STE C189
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City | LOS ANGELES
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State | CA
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Zip | 90027-3480
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Country | US
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Telephone | 818-451-3461
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 19997
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License Number State | CA
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