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General NPI Number Information
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NPI Number | 1851818165
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Entity Type | Individual
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Provider Name | MICHAEL MACKENZIE CHIU PT
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Gender | Male
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Dates
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Enumeration Date | 08/28/2017
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Last Update Date | 08/28/2017
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Provider Practice Location Address
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Address Line | 215 N STATE COLLEGE BLVD STE G
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City | ANAHEIM
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State | CA
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Zip | 92806-2932
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Country | US
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Telephone | 714-999-6596
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Fax |
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Provider Business Mailing Address
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Address Line | 21870 MACKENZIE AVE
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City | YORBA LINDA
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State | CA
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Zip | 92887-3935
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Country | US
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Telephone | 714-777-0681
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Fax |
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 293665
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License Number State | CA
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