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General NPI Number Information
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NPI Number | 1841280989
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Entity Type | Individual
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Provider Name | DAVID MICHAEL REDMAN O.D.
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Gender | Male
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Dates
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Enumeration Date | 10/27/2005
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Last Update Date | 10/20/2011
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Provider Practice Location Address
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Address Line | 117 BERNAL RD SUITE 40
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City | SAN JOSE
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State | CA
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Zip | 95119-1375
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Country | US
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Telephone | 408-362-9789
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Fax | 408-362-9790
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Provider Business Mailing Address
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Address Line | 1039 EL MONTE AVE SUITE K
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-2370
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Country | US
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Telephone | 650-967-0140
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Fax | 650-967-3925
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 9692T
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License Number State | CA
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