NPI
LastName
FirstName
MidName
Organization
Mailing Address
City
State
Zip
1710487962
FACULTY PHYSICIANS AND SURGEONS OF LLUSM
FILE NUMBER 54701
LOS ANGELES
CA
900744701
1699279679
KARYADI
KENNY
A
268 W HOSPITALITY LN
SAN BERNARDINO
CA
924083241
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