{
"Npi": {
"NPI": "1154413516",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HOSEIN MOHAMMADI, M.D., 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": "10120 DUTCH IRIS DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BAKERSFIELD",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "93311-3770",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "661-664-3670",
"MailingAddressFaxNumber": "661-664-7929",
"FirstLinePracticeLocationAddress": "5000 PHYSICIANS BLVD",
"SecondLinePracticeLocationAddress": "SUITE 100",
"PracticeLocationAddressCityName": "BAKERSFIELD",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "93301-5835",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "661-846-4985",
"PracticeLocationAddressFaxNumber": "661-846-3930",
"EnumerationDate": "09/29/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MOHAMMADI",
"AuthorizedOfficialFirstName": "HOSEIN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "661-846-4985",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "174400000X",
"TaxonomyName": "Specialist",
"LicenseNumber": "00A338200",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}