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General NPI Number Information
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NPI Number | 1942282934
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Entity Type | Individual
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Provider Name | RITA ROSALIE PERRELLA MD
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Gender | Female
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Dates
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Enumeration Date | 11/16/2005
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Last Update Date | 04/18/2014
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Provider Practice Location Address
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Address Line | 2121 WILSHIRE BLVD #303
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City | SANTA MONICA
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State | CA
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Zip | 90403
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Country | US
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Telephone | 310-613-5505
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Fax | 310-828-8162
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Provider Business Mailing Address
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Address Line | 2121 WILSHIRE BLVD. #303
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City | SANTA MONICA
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State | CA
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Zip | 90403
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Country | US
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Telephone | 310-613-5505
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Fax | 310-828-8162
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | G52811
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License Number State | CA
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