{
"Npi": {
"NPI": "1194822320",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "METRO-MED, INC. - LOS ALAMITOS",
"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": "8999 GEMINI PKWY STE 220",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "COLUMBUS",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "43240-2250",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "614-573-9075",
"MailingAddressFaxNumber": "614-568-5290",
"FirstLinePracticeLocationAddress": "10841 NOEL ST",
"SecondLinePracticeLocationAddress": "STE. 108, 103",
"PracticeLocationAddressCityName": "LOS ALAMITOS",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90720-2597",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "714-761-9761",
"PracticeLocationAddressFaxNumber": "714-761-8455",
"EnumerationDate": "09/20/2006",
"LastUpdateDate": "09/15/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "YAEGER",
"AuthorizedOfficialFirstName": "JAMES",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "818-840-9090",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "332BX2000X",
"TaxonomyName": "Oxygen Equipment & Supplies (DME)",
"LicenseNumber": "100347",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": "100347",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}