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General NPI Number Information
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NPI Number | 1902046428
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Entity Type | Organization
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Legal Business Name | MAHDI PARIDARI, M.D. INC.
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Dates
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Enumeration Date | 02/23/2009
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Last Update Date | 03/18/2009
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Provider Practice Location Address
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Address Line | 22030 SHERMAN WAY STE 105
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City | CANOGA PARK
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State | CA
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Zip | 91303-3016
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Country | US
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Telephone | 818-585-5595
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Fax | 818-887-1805
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Provider Business Mailing Address
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Address Line | 22405 GILMORE ST
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City | WEST HILLS
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State | CA
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Zip | 91307-3707
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Country | US
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Telephone | 818-585-5595
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Fax | 818-887-1805
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MAHDI PARIDARI
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Credential | M.D.
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Telephone | 18185855595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | A98666
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License Number State | CA
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