{
"Npi": {
"NPI": "1073752820",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MEDICALSTATIONSUPPLY",
"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": "120 N ELM DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BEVERLY HILLS",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90210-5510",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "310-279-0624",
"MailingAddressFaxNumber": "213-612-4936",
"FirstLinePracticeLocationAddress": "1143 S LOS ANGELES ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LOS ANGELES",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90015-2536",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "310-770-7309",
"PracticeLocationAddressFaxNumber": "213-612-4936",
"EnumerationDate": "02/18/2009",
"LastUpdateDate": "02/18/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "AZIZI",
"AuthorizedOfficialFirstName": "DANIEL",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "TREASURER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "310-279-0642",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}