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General NPI Number Information
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NPI Number | 1972190932
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Entity Type | Individual
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Provider Name | KAREEN DILLARD
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Gender | Female
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Dates
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Enumeration Date | 12/24/2020
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Last Update Date | 12/24/2020
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Provider Practice Location Address
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Address Line | 2540 ROYAL CREST DR
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City | ESCONDIDO
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State | CA
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Zip | 92025-7316
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Country | US
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Telephone | 760-807-9242
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Fax |
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Provider Business Mailing Address
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Address Line | 4150 VIOLET ST
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City | LA MESA
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State | CA
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Zip | 91941-7546
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Country | US
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Telephone | 619-882-0637
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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 | 2472R0900X
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Taxonomy Name | Renal Dialysis Technician
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License Number |
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License Number State |
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