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General NPI Number Information
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NPI Number | 1922536424
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Entity Type | Organization
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Legal Business Name | ARDHA MOBILE MD LLC
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Dates
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Enumeration Date | 05/27/2017
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Last Update Date | 05/27/2017
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Provider Practice Location Address
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Address Line | 270 E 7TH ST STE 1A
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City | UPLAND
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State | CA
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Zip | 91786-6602
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Country | US
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Telephone | 213-400-5750
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Fax |
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Provider Business Mailing Address
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Address Line | 5817 ETIWANDA AVE
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City | TARZANA
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State | CA
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Zip | 91356-2473
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Country | US
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Telephone | 213-400-5750
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | CARLOTA ESPINO
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Credential |
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Telephone | 213-400-5750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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