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Individual
MARK A HYATT
Active
Individual
MARK A HYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC II
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
18601206
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18601206
CADCA
CA
Enumeration date
03/16/2007
Last updated
11/20/2007
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