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General NPI Number Information
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NPI Number | 1861744534
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Entity Type | Individual
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Provider Name | ANH BAO LE PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 10/05/2012
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Last Update Date | 06/12/2014
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Provider Practice Location Address
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Address Line | 9300 VALLEY CHILDRENS PL
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City | MADERA
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State | CA
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Zip | 93636-8761
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Country | US
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Telephone | 559-353-5502
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Fax |
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Provider Business Mailing Address
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Address Line | 682 KAWEAH AVE
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City | CLOVIS
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State | CA
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Zip | 93619-6905
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Country | US
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Telephone | 267-974-8073
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 57721
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP439412
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License Number State | PA
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