{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "KIRTI TALOLE MD INC",
"LastName": null,
"FirstName": null,
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"NameSuffix": null,
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"FirstLineMailingAddress": "6301 GLADE AVE",
"SecondLineMailingAddress": "K213",
"MailingAddressCityName": "WOODLAND HILLS",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91367-1939",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "818-852-9320",
"MailingAddressFaxNumber": "818-350-1105",
"FirstLinePracticeLocationAddress": "6301 GLADE AVE",
"SecondLinePracticeLocationAddress": "K213",
"PracticeLocationAddressCityName": "WOODLAND HILLS",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91367-1939",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "818-852-9320",
"PracticeLocationAddressFaxNumber": "818-350-1105",
"EnumerationDate": "12/04/2016",
"LastUpdateDate": "12/04/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TALOLE",
"AuthorizedOfficialFirstName": "KIRTI",
"AuthorizedOfficialMiddleName": "SOPAN",
"AuthorizedOfficialTitle": "PHYSICIAN/OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "818-852-9320",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207R00000X",
"TaxonomyName": "Internal Medicine Physician",
"LicenseNumber": "C132757",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}