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General NPI Number Information
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NPI Number | 1821375841
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Entity Type | Individual
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Provider Name | ERIC JOHN ANDERSON RCP
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Gender | Male
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Dates
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Enumeration Date | 11/04/2011
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Last Update Date | 06/25/2015
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Provider Practice Location Address
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Address Line | 2059 JAYBROOK DR
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City | RANCHO PALOS VERDES
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State | CA
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Zip | 90275-2033
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Country | US
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Telephone | 310-701-6383
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Fax | 310-684-1311
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Provider Business Mailing Address
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Address Line | 2059 JAYBROOK DR
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City | RANCHO PALOS VERDES
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State | CA
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Zip | 90275-2033
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Country | US
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Telephone | 310-701-6383
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Fax | 310-684-1311
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 227800000X
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Taxonomy Name | Certified Respiratory Therapist
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License Number | 24569
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License Number State | CA
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