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General NPI Number Information
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NPI Number | 1780218958
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Entity Type | Organization
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Legal Business Name | MOELLER NATUROPATHIC MEDICINE, INC
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Dates
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Enumeration Date | 02/26/2020
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Last Update Date | 02/26/2020
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Provider Practice Location Address
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Address Line | 25301 CABOT RD STE 103
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-5511
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Country | US
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Telephone | 949-485-4835
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Fax |
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Provider Business Mailing Address
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Address Line | 1166 LARKSPUR LN
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City | CARLSBAD
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State | CA
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Zip | 92008-3405
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | HOVSEP SEMERDJIAN
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Credential |
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Telephone | 949-485-4835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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