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General NPI Number Information
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NPI Number | 1871760918
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Entity Type | Individual
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Provider Name | BAHMAN BEN SHAMLOO M.D
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Gender | Male
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Dates
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Enumeration Date | 05/08/2008
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Last Update Date | 01/26/2023
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Provider Practice Location Address
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Address Line | 8631 W 3RD ST STE 815E
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City | LOS ANGELES
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State | CA
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Zip | 90048-5901
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Country | US
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Telephone | 310-246-2358
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Fax | 424-285-8534
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Provider Business Mailing Address
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Address Line | 8631 W 3RD ST STE 815E
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City | LOS ANGELES
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State | CA
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Zip | 90048-5901
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Country | US
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Telephone | 310-246-2358
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Fax | 424-285-8534
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A103444
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License Number State | CA
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