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General NPI Number Information
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NPI Number | 1881092781
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Entity Type | Organization
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Legal Business Name | M4LLC
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Dates
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Enumeration Date | 12/09/2014
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Last Update Date | 12/09/2014
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Provider Practice Location Address
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Address Line | 30923 CARTIER DR
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City | RANCHO PALOS VERDES
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State | CA
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Zip | 90275-5633
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Country | US
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Telephone | 760-686-3121
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Fax |
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Provider Business Mailing Address
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Address Line | 30923 CARTIER DR
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City | RANCHO PALOS VERDES
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State | CA
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Zip | 90275-5633
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Country | US
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Telephone | 760-686-3121
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MOSTAFA S RAHIMI
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Credential | MD
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Telephone | 760-686-3121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A89780
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License Number State | CA
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