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General NPI Number Information
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NPI Number | 1730791864
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Entity Type | Organization
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Legal Business Name | REZA SHAHBAZ, M.D. INC.
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Dates
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Enumeration Date | 08/19/2020
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Last Update Date | 08/19/2020
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Provider Practice Location Address
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Address Line | 2601 E CHAPMAN AVE
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City | ORANGE
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State | CA
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Zip | 92869-3206
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Country | US
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Telephone | 949-800-9744
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Fax |
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Provider Business Mailing Address
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Address Line | 402 ROCKEFELLER UNIT 214
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City | IRVINE
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State | CA
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Zip | 92612-8105
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Country | US
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Telephone | 979-800-9744
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | REZA SHAHBAZ
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Credential | MD
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Telephone | 949-800-9744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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