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General NPI Number Information
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NPI Number | 1780569210
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Entity Type | Organization
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Legal Business Name | MIRACLE MOBILE WOUND CARE
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Dates
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Enumeration Date | 08/06/2025
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 2450 COLORADO AVE STE 100E
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City | SANTA MONICA
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State | CA
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Zip | 90404-5535
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Country | US
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Telephone | 310-453-1324
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Fax |
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Provider Business Mailing Address
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Address Line | 1322 S BARRINGTON AVE
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City | LOS ANGELES
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State | CA
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Zip | 90025-1602
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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 | OWNER
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Name | MICHAEL TOISERKANI
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Credential | MD
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Telephone | 310-453-1324
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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