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General NPI Number Information
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NPI Number | 1992774681
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Entity Type | Individual
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Provider Name | DANIEL TAHERI M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/15/2006
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 10884 SANTA MONICA BLVD 3RD FLOOR
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City | LOS ANGELES
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State | CA
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Zip | 90025-4646
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Country | US
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Telephone | 310-446-4400
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Fax | 310-446-4408
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Provider Business Mailing Address
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Address Line | 2409 ARTESIA BLVD FL 2
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City | REDONDO BEACH
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State | CA
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Zip | 90278-3207
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Country | US
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Telephone | 424-276-4700
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Fax | 424-903-1099
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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 | G80445
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | G80445
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License Number State | CA
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