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General NPI Number Information
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NPI Number | 1891028239
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Entity Type | Organization
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Legal Business Name | WEST REGIONAL CARDIOTHORACIC & VASCULAR SURGEONS W R VEIN CENTER
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Dates
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Enumeration Date | 09/17/2009
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Last Update Date | 07/28/2023
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Provider Practice Location Address
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Address Line | 4527 E CESAR CHAVEZ
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City | LOS ANGELES
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State | CA
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Zip | 90022-1116
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Country | US
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Telephone | 323-262-9299
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Fax |
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Provider Business Mailing Address
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Address Line | 5850 CANOGA AVE STE 400
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-6554
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Country | US
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Telephone | 805-910-7390
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | HAROLD A TABAIE
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Credential | D.O.
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Telephone | 941-720-0731
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number |
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License Number State |
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