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General NPI Number Information
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NPI Number | 1891703989
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Entity Type | Individual
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Provider Name | JAIME MOY DO
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Gender | Female
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 11/10/2011
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Provider Practice Location Address
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Address Line | 2219 E 1ST ST
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City | LOS ANGELES
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State | CA
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Zip | 90033-3901
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Country | US
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Telephone | 323-269-0421
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Fax | 323-780-9432
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Provider Business Mailing Address
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Address Line | 10418 VALLEY BLVD STE B
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City | EL MONTE
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State | CA
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Zip | 91731-3600
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Country | US
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Telephone | 626-453-8466
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 20A8734
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License Number State | CA
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