{
"Npi": {
"NPI": "1134586456",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SAN DIEGO ENDOCRINE AND MEDICAL CLINIC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherLastName": null,
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"OtherNamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "7189 AVIARA DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CARLSBAD",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92011-4901",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "760-918-1683",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "7189 AVIARA DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CARLSBAD",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92011-4901",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "760-918-1683",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/17/2016",
"LastUpdateDate": "01/17/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WEISS",
"AuthorizedOfficialFirstName": "STUART",
"AuthorizedOfficialMiddleName": "ROLLIN",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "619-933-2675",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM2500X",
"TaxonomyName": "Medical Specialty Clinic/Center",
"LicenseNumber": "G31180",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}