{
"Npi": {
"NPI": "1174078315",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SHAIDA BEHNAM MD INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1010 CASS ST STE D3",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MONTEREY",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "93940-4515",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "831-901-3691",
"MailingAddressFaxNumber": "831-901-3706",
"FirstLinePracticeLocationAddress": "1010 CASS ST STE D3",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MONTEREY",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "93940",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "831-901-3691",
"PracticeLocationAddressFaxNumber": "831-901-3706",
"EnumerationDate": "08/17/2016",
"LastUpdateDate": "08/31/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BEHNAM",
"AuthorizedOfficialFirstName": "SHAIDA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "925-640-1980",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": "A82694",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}