{
"Npi": {
"NPI": "1043304769",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FAMILY PLANNING ASSOCIATES MEDICAL GROUP 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": "2777 LONG BEACH BLVD STE 200",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LONG BEACH",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90806-1513",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "562-595-5653",
"MailingAddressFaxNumber": "562-595-4247",
"FirstLinePracticeLocationAddress": "2777 LONG BEACH BLVD",
"SecondLinePracticeLocationAddress": "SUITE200",
"PracticeLocationAddressCityName": "LONG BEACH",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90806-1571",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "562-595-5653",
"PracticeLocationAddressFaxNumber": "909-494-7660",
"EnumerationDate": "10/03/2006",
"LastUpdateDate": "08/29/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FELDKAMP IV",
"AuthorizedOfficialFirstName": "IRVING",
"AuthorizedOfficialMiddleName": "M.",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": "IV",
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "909-382-0201",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "207V00000X",
"TaxonomyName": "Obstetrics & Gynecology Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QA0005X",
"TaxonomyName": "Ambulatory Family Planning Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}