{
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"FirstLineMailingAddress": "3334 E COAST HWY STE 605",
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"MailingAddressCityName": "CORONA DEL MAR",
"MailingAddressStateName": "CA",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "480-236-8868",
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"FirstLinePracticeLocationAddress": "520 ROSE LN",
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"PracticeLocationAddressCityName": "WICKENBURG",
"PracticeLocationAddressStateName": "AZ",
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"EnumerationDate": "08/27/2024",
"LastUpdateDate": "08/27/2024",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HEDAYATI",
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"Taxonomies": {
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"TaxonomyName": "Radiology Clinic/Center",
"LicenseNumber": null,
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}