{
"Npi": {
"NPI": "1053726943",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HB SURGERY CENTER, 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": "1601 PACIFIC COAST HWY",
"SecondLineMailingAddress": "STE 150",
"MailingAddressCityName": "HERMOSA BEACH",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90254-3213",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "310-571-9922",
"MailingAddressFaxNumber": "310-861-5001",
"FirstLinePracticeLocationAddress": "1601 PACIFIC COAST HWY",
"SecondLinePracticeLocationAddress": "STE 150",
"PracticeLocationAddressCityName": "HERMOSA BEACH",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90254-3213",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "310-402-2255",
"PracticeLocationAddressFaxNumber": "310-376-1391",
"EnumerationDate": "06/30/2014",
"LastUpdateDate": "01/25/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PRINCE",
"AuthorizedOfficialFirstName": "CYNTHIA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DON",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN",
"AuthorizedOfficialTelephoneNumber": "310-571-9922",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QA1903X",
"TaxonomyName": "Ambulatory Surgical Clinic/Center",
"LicenseNumber": "A107345",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}