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General NPI Number Information
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NPI Number | 1780874222
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Entity Type | Organization
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Legal Business Name | A MICHAEL MOHEIMANI MD INC
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Dates
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Enumeration Date | 07/31/2007
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Last Update Date | 01/18/2023
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Provider Practice Location Address
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Address Line | 801 N TUSTIN AVE STE 403
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City | SANTA ANA
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State | CA
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Zip | 92705-3608
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Country | US
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Telephone | 714-285-0014
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Fax | 714-285-0018
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Provider Business Mailing Address
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Address Line | 801 N TUSTIN AVE STE 403
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City | SANTA ANA
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State | CA
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Zip | 92705-3608
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Country | US
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Telephone | 714-285-0014
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Fax | 714-285-0018
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. SHAMSI MOHEIMANI
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Credential |
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Telephone | 714-285-0014
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 316659
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License Number State | CA
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