{
"Npi": {
"NPI": "1134442395",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DAVID H PAYNE MD INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 465",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TUSTIN",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92781-0465",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "714-271-9112",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1902 ROYALTY DR",
"SecondLinePracticeLocationAddress": "#260",
"PracticeLocationAddressCityName": "POMONA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91767-3030",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "909-397-0833",
"PracticeLocationAddressFaxNumber": "909-397-0933",
"EnumerationDate": "03/02/2010",
"LastUpdateDate": "03/02/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PAYNE",
"AuthorizedOfficialFirstName": "DAVID",
"AuthorizedOfficialMiddleName": "H",
"AuthorizedOfficialTitle": "PRESIDENT/OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "714-271-9112",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207X00000X",
"TaxonomyName": "Orthopaedic Surgery Physician",
"LicenseNumber": "G62826",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}