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General NPI Number Information
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NPI Number | 1942707880
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Entity Type | Individual
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Provider Name | SHISHIR RAO
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Gender | Male
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Dates
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Enumeration Date | 04/08/2018
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 2020 ZONAL AVE # 720
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City | LOS ANGELES
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State | CA
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Zip | 90089-0121
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Country | US
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Telephone | 520-626-2761
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Fax | 520-626-6020
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Provider Business Mailing Address
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Address Line | 2020 ZONAL AVE STE 720
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City | LOS ANGELES
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State | CA
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Zip | 90089-0121
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Country | US
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Telephone | 323-409-7184
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | R2958
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 009092
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 20A19987
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License Number State | CA
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