{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ANTONIO SOTO JR DC CHIROPRACTIC PROFESSIONAL CORPORATION",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1212 WEST ROBINHOOD DRIVE",
"SecondLineMailingAddress": "SUITE 1F",
"MailingAddressCityName": "STOCKTON",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95207",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "209-474-8215",
"MailingAddressFaxNumber": "209-474-8953",
"FirstLinePracticeLocationAddress": "1212 WEST ROBINHOOD DRIVE",
"SecondLinePracticeLocationAddress": "SUITE 1F",
"PracticeLocationAddressCityName": "STOCKTON",
"PracticeLocationAddressStateName": "CA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "209-474-8215",
"PracticeLocationAddressFaxNumber": "209-474-8953",
"EnumerationDate": "03/07/2007",
"LastUpdateDate": "06/26/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SOTO",
"AuthorizedOfficialFirstName": "ANTONIO",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER DOCTOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "209-474-8215",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "DC21575",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "111N00000X",
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},
{
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "DC13684",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": [
{
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
},
{
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
},
{
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
}
]
}
}
}