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General NPI Number Information
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NPI Number | 1740594092
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Entity Type | Individual
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Provider Name | RICHARD T SCUDERI MD
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Gender | Male
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Dates
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Enumeration Date | 07/28/2010
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Last Update Date | 07/28/2010
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Provider Practice Location Address
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Address Line | 7901 FROST ST
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City | SAN DIEGO
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State | CA
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Zip | 92123-2701
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Country | US
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Telephone | 858-939-3660
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10076
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City | VAN NUYS
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State | CA
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Zip | 91410-0076
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Country | US
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Telephone | 805-578-8300
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Fax | 805-578-3911
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | A96892
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License Number State | CA
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