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General NPI Number Information
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NPI Number | 1730649799
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Entity Type | Organization
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Legal Business Name | NIAMEDIC BH PC
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Dates
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Enumeration Date | 03/24/2019
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Last Update Date | 03/24/2019
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Provider Practice Location Address
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Address Line | 24411 HEALTH CENTER DR STE 330
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-3633
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Country | US
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Telephone | 833-364-2633
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Fax | 833-364-2633
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Provider Business Mailing Address
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Address Line | 24411 HEALTH CENTER DR STE 330
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-3633
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Country | US
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Telephone | 833-364-2633
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Fax | 833-364-2633
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHAHBAZ FARNAD
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Credential | MD
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Telephone | 833-364-2633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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