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NPI 1861854465

NPI 1861854465 : UYEN DUONG : LOS ANGELES, CA

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General NPI Number Information
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    NPI Number           |    1861854465
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    Entity Type          |    Individual 
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    Provider Name        |    UYEN DUONG
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/23/2016
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    Last Update Date     |    03/23/2016
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Provider Practice Location Address
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    Address Line         |    11301 WILSHIRE BLVD # 119 BUILDING 500, ROOM 6042
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90073-1003
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    Country              |    US
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    Telephone            |    310-951-3190
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4322 W 182ND ST APT 2 
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    City                 |    TORRANCE
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    State                |    CA
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    Zip                  |    90504-4528
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    Country              |    US
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    Telephone            |    
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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        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    CA
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