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General NPI Number Information
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NPI Number | 1962520429
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Entity Type | Individual
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Provider Name | ROBERT JENE HOAGLAND D.C.
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Gender | Male
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 10/19/2012
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Provider Practice Location Address
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Address Line | 381 1ST ST
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City | LOS ALTOS
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State | CA
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Zip | 94022-3605
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Country | US
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Telephone | 650-941-1723
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Fax | 650-917-1896
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Provider Business Mailing Address
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Address Line | 381 FIRST ST.
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City | LOS ALTOS
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State | CA
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Zip | 94022-3634
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Country | US
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Telephone | 650-387-4049
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 22368
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License Number State | CA
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