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General NPI Number Information
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NPI Number | 1922569961
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Entity Type | Individual
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Provider Name | MANUCHEHR HABIBI MD
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Gender | Male
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Dates
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Enumeration Date | 03/30/2019
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 2755 HERNDON AVE
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City | CLOVIS
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State | CA
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Zip | 93611-6800
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Country | US
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Telephone | 559-324-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 3234 QUINCY AVE
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City | CLOVIS
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State | CA
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Zip | 93619-8120
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Country | US
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Telephone | 619-203-7549
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 75280
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | U2862
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License Number State | TX
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