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General NPI Number Information
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NPI Number | 1801252762
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Entity Type | Organization
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Legal Business Name | MIA M. LAGUNDA, MD, INC.
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Dates
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Enumeration Date | 01/07/2016
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Last Update Date | 01/07/2016
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Provider Practice Location Address
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Address Line | 6001 TRUXTUN AVE SUITE 210B
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City | BAKERSFIELD
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State | CA
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Zip | 93309-0679
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Country | US
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Telephone | 661-847-9705
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Fax |
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Provider Business Mailing Address
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Address Line | 6001 TRUXTUN AVE SUITE 210B
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City | BAKERSFIELD
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State | CA
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Zip | 93309-0679
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Country | US
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Telephone | 661-847-9705
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Fax |
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Authorized Official
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Title or Position | PROVIDER/PRESIDENT
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Name | DR. MIA M LAGUNDA
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Credential | MD
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Telephone | 661-847-9705
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | C51016
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License Number State | CA
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