ProviderBusinessMailingAddressFaxNumber = '5105247608'
NPI
LastName
FirstName
MidName
Organization
Mailing Address
City
State
Zip
1003806001
LIU
BARRY
RANDALL
914 THE ALAMEDA
BERKELEY
CA
947072308
1740407378
STARK
RONALD
BRIAN
9 ROSE CT
SAUSALITO
CA
949652065
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