{
"Npi": {
"NPI": "1215040217",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CHAU",
"FirstName": "TONY TOT",
"MiddleName": "VAN",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "PHARM.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "CHAU",
"OtherFirstName": "TOT",
"OtherMiddleName": "VAN",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "PHARM.D.",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "7726 E WALNUT RIDGE RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ORANGE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92869-6515",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "909-825-7084",
"MailingAddressFaxNumber": "909-777-3849",
"FirstLinePracticeLocationAddress": "11201 BENTON ST",
"SecondLinePracticeLocationAddress": "ROUTE 119",
"PracticeLocationAddressCityName": "LOMA LINDA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92357-1000",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "909-825-7084",
"PracticeLocationAddressFaxNumber": "909-777-3849",
"EnumerationDate": "08/16/2006",
"LastUpdateDate": "07/19/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1835P0018X",
"TaxonomyName": "Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"LicenseNumber": "PS30737",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}