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General NPI Number Information
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NPI Number | 1962057869
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Entity Type | Organization
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Legal Business Name | CIARA V JOHNSON MD INC.
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Dates
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Enumeration Date | 08/07/2019
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Last Update Date | 08/07/2019
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Provider Practice Location Address
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Address Line | 1635 CANDACE WAY
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City | LOS ALTOS
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State | CA
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Zip | 94024-6243
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Country | US
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Telephone | 650-575-3825
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Fax |
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Provider Business Mailing Address
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Address Line | 1635 CANDACE WAY
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City | LOS ALTOS
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State | CA
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Zip | 94024-6243
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. CIARA JOHNSON
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Credential | MD
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Telephone | 650-575-3825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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