{
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"FirstLineMailingAddress": "800 E WASHINGTON BLVD",
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"MailingAddressCityName": "CRESCENT CITY",
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"MailingAddressTelephoneNumber": "707-464-8511",
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"FirstLinePracticeLocationAddress": "785 E WASHINGTON BLVD STE 15",
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"EnumerationDate": "06/10/2026",
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "POPADIC",
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"Taxonomies": {
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}
},
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}
}