{
"Npi": {
"NPI": "1164760575",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "NORTHERN OC ENT MEDICAL CORP",
"ParentOrgTIN": null,
"OrgName": "NORTHERN OC ENT PROPERTIES LLC",
"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": "1955 SUNNYCREST DR STE 108",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FULLERTON",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92835-3653",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "714-441-0133",
"MailingAddressFaxNumber": "714-441-1082",
"FirstLinePracticeLocationAddress": "1955 SUNNYCREST DR STE 108",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FULLERTON",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92835-3653",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "714-441-0133",
"PracticeLocationAddressFaxNumber": "714-441-1082",
"EnumerationDate": "01/18/2013",
"LastUpdateDate": "01/18/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HODGES",
"AuthorizedOfficialFirstName": "ANN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OFFICE MANAGER",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "714-441-0133",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332S00000X",
"TaxonomyName": "Hearing Aid Equipment",
"LicenseNumber": "201135710289",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}