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General NPI Number Information
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NPI Number | 1831495571
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Entity Type | Organization
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Legal Business Name | ATALANTA C OLITO OSTEOPATHIC CORP
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Dates
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Enumeration Date | 01/27/2011
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Last Update Date | 01/27/2011
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Provider Practice Location Address
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Address Line | 8945 MAGNOLIA AVE 200
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City | RIVERSIDE
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State | CA
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Zip | 92503-4436
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Country | US
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Telephone | 951-688-7270
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3098
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City | TORRANCE
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State | CA
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Zip | 90510-3098
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Country | US
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Telephone | 310-792-3914
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ATALANTA C OLITO
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Credential | D.O.
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Telephone | 310-792-3914
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 20A6471
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License Number State | CA
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