{
"Npi": {
"NPI": "1174128482",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "LEON YAN MD",
"ParentOrgTIN": null,
"OrgName": "LEON YAN MD",
"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": "29995 TECHNOLOGY DR STE 100",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MURRIETA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92563-2632",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "951-412-1610",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "29995 TECHNOLOGY DR STE 100",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MURRIETA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92563-2632",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "951-412-1610",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/03/2020",
"LastUpdateDate": "12/04/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "YAN",
"AuthorizedOfficialFirstName": "LEON",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "MD/OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "951-412-1610",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "261QM1300X",
"TaxonomyName": "Multi-Specialty Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}