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General NPI Number Information
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NPI Number | 1992190417
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Entity Type | Individual
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Provider Name | ARDESHIR EDWARD NADIMI M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/01/2015
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Last Update Date | 12/20/2025
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Provider Practice Location Address
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Address Line | 12555 W JEFFERSON BLVD STE 202
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City | LOS ANGELES
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State | CA
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Zip | 90066-7047
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Country | US
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Telephone | 424-541-1756
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Fax |
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Provider Business Mailing Address
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Address Line | 13700 MARINA POINTE DR UNIT 721
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City | MARINA DEL REY
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State | CA
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Zip | 90292-9261
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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 |
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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 | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | A168788
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License Number State | CA
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