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Individual
KEVIN MAO
Active
Individual
KEVIN MAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
38307
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ21382Z
MEDICARE
CA
Enumeration date
11/04/2011
Last updated
11/04/2011
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