{
"Npi": {
"NPI": "1023665494",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SAMA HEALTHCARE INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "191 GROVELAND",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "IRVINE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92620-2826",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "805-720-4563",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "105 W BASTANCHURY RD STE D",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FULLERTON",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92835-2525",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "714-500-7727",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/21/2019",
"LastUpdateDate": "01/05/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "IBRAHIM",
"AuthorizedOfficialFirstName": "SAMAH",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PIC/CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "714-500-7727",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}