{
"Npi": {
"NPI": "1154717619",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "RAO",
"FirstName": "NICKI",
"MiddleName": "VITHALANI",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "M.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "VITHALANI",
"OtherFirstName": "NICKI",
"OtherMiddleName": "DINESH",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "MD",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "5555 GROSSMONT CENTER DR",
"SecondLineMailingAddress": "ATTN AIM/PALLIATIVE CARE",
"MailingAddressCityName": "SAN DIEGO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91942",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "5555 GROSSMONT CENTER DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LA MESA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91942-3019",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "619-740-6000",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/11/2015",
"LastUpdateDate": "07/28/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "207QH0002X",
"TaxonomyName": "Hospice and Palliative Medicine (Family Medicine) Physician",
"LicenseNumber": "MD467593",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207QH0002X",
"TaxonomyName": "Hospice and Palliative Medicine (Family Medicine) Physician",
"LicenseNumber": "151429",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}