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General NPI Number Information
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NPI Number | 1750302204
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Entity Type | Individual
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Provider Name | MICHELE MOZELSIO P.A.
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Gender | Female
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 50 LECH WALESA TOM WADDELL HEALTH CENTER
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City | SAN FRANCISCO
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State | CA
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Zip | 94102-4506
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Country | US
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Telephone | 415-355-7400
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Fax | 415-355-7402
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Provider Business Mailing Address
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Address Line | 1426 WALLER ST APT 6
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City | SAN FRANCISCO
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State | CA
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Zip | 94117-2954
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Country | US
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Telephone | 415-863-4048
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA17712
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License Number State | CA
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