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General NPI Number Information
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NPI Number | 1881914646
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Entity Type | Organization
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Legal Business Name | K KAY DURAIRAJ MD A MEDICAL CORPORATION
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Dates
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Enumeration Date | 06/03/2010
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Last Update Date | 10/10/2012
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Provider Practice Location Address
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Address Line | 800 S. FAIRMOUNT AVE
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City | PASADENA
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State | CA
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Zip | 91105-3152
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Country | US
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Telephone | 626-316-7033
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Fax | 626-539-2529
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Provider Business Mailing Address
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Address Line | 800 S. FAIRMOUNT AVE SUITE 210
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City | PASADENA
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State | CA
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Zip | 91105-3152
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Country | US
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Telephone | 626-316-7033
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Fax | 626-539-2529
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. KAY DURAIRAJ
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Credential | MD
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Telephone | 62633167033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | A56015
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License Number State | CA
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