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General NPI Number Information
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NPI Number | 1891181673
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Entity Type | Individual
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Provider Name | RENEE FINE BOGOMOLNY D.C.
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Gender | Female
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Dates
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Enumeration Date | 04/08/2015
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 2812 SANTA MONICA BLVD SUITE 208
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City | SANTA MONICA
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State | CA
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Zip | 90404-2476
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Country | US
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Telephone | 310-488-7277
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Fax |
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Provider Business Mailing Address
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Address Line | 4624 MALEZA PL
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City | TARZANA
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State | CA
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Zip | 91356-4721
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Country | US
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Telephone | 310-844-5502
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Fax |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 33231
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License Number State | CA
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