{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"FirstName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "15823 AVIATION CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CHINO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91708-7617",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "951-365-3434",
"MailingAddressFaxNumber": "951-905-1609",
"FirstLinePracticeLocationAddress": "2079 COMPTON AVE STE 105",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CORONA",
"PracticeLocationAddressStateName": "CA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "951-365-3434",
"PracticeLocationAddressFaxNumber": "951-905-1609",
"EnumerationDate": "03/17/2020",
"LastUpdateDate": "03/17/2020",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PATEL",
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"AuthorizedOfficialCredential": "PHARM D",
"AuthorizedOfficialTelephoneNumber": "513-442-8078",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "3336S0011X",
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"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336L0003X",
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}
]
},
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}
}