{
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"FirstLineMailingAddress": "1545 W FLORIDA AVE",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "951-791-1111",
"MailingAddressFaxNumber": "888-856-3893",
"FirstLinePracticeLocationAddress": "949 CALHOUN PL STE G",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "951-765-5594",
"PracticeLocationAddressFaxNumber": "888-662-4491",
"EnumerationDate": "03/26/2007",
"LastUpdateDate": "04/24/2025",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": "F",
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"Taxonomies": {
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"TaxonomyName": "Family Medicine Physician",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}