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General NPI Number Information
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NPI Number | 1871758367
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Entity Type | Organization
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Legal Business Name | MAURICE S. HABER, M.D. A MEDICAL CORPORATION
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Dates
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Enumeration Date | 07/23/2008
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Last Update Date | 07/16/2013
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Provider Practice Location Address
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Address Line | 12626 RIVERSIDE DR #506
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City | VALLEY VILLAGE
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State | CA
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Zip | 91607-3420
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Country | US
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Telephone | 818-766-5231
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Fax | 818-766-9083
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Provider Business Mailing Address
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Address Line | 12626 RIVERSIDE DR STE 506
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City | VALLEY VILLAGE
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State | CA
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Zip | 91607-3461
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Country | US
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Telephone | 818-766-5231
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Fax | 818-766-9083
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Authorized Official
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Title or Position | M.D.
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Name | MAURICE S. HABER
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Credential | M.D.
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Telephone | 818-766-5231
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | A28340
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License Number State | CA
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