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General NPI Number Information
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NPI Number | 1790815082
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Entity Type | Organization
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Legal Business Name | LOS ANGELES LUNG CENTER A PROFESSIONAL MEDICAL CORP
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 1300 N VERMONT AVE STE 902
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City | LOS ANGELES
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State | CA
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Zip | 90027-6094
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Country | US
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Telephone | 323-913-9130
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Fax | 323-913-9140
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Provider Business Mailing Address
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Address Line | PO BOX 480481
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City | LOS ANGELES
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State | CA
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Zip | 90048-1481
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Country | US
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Telephone | 323-913-9130
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Fax | 213-977-0656
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BABAK BOB ABRISHAMI
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Credential | D.O.
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Telephone | 323-913-9130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 20A7450
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License Number State | CA
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