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General NPI Number Information
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NPI Number | 1922357821
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Entity Type | Organization
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Legal Business Name | REZA FAROKHPAY MD INC APC
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Dates
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Enumeration Date | 09/06/2012
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Last Update Date | 09/06/2012
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Provider Practice Location Address
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Address Line | 10802 COLLEGE PLACE
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City | CERRITOS
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State | CA
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Zip | 90703-1505
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Country | US
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Telephone | 714-940-0941
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Fax | 714-940-0944
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Provider Business Mailing Address
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Address Line | P.O. BOX 2089
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City | ARTESIA
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State | CA
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Zip | 90702-2089
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Country | US
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Telephone | 714-940-0941
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Fax | 714-940-0944
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Authorized Official
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Title or Position | OWNER / PROVIDER
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Name | REZA FAROKHPAY
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Credential | M.D.
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Telephone | 949-929-5984
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A108097
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License Number State | CA
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