{
"Npi": {
"NPI": "1073668521",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LOS ANGELES COUNTY - RESEDA MTU",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "9320 TELSTAR AVE STE 226",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "EL MONTE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91731-2849",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "19451 WYANDOTTE ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "RESEDA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91335-3518",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "818-885-6244",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/24/2007",
"LastUpdateDate": "01/25/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FORD",
"AuthorizedOfficialFirstName": "WESLEY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DIRECTOR, CMS",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "626-569-6001",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QR0400X",
"TaxonomyName": "Rehabilitation Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}