{
"Npi": {
"NPI": "1215350327",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JEEVA LLC",
"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": "501 W GLENOAKS BLVD",
"SecondLineMailingAddress": "SUITE#12",
"MailingAddressCityName": "GLENDALE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91202-2896",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "818-500-1517",
"MailingAddressFaxNumber": "818-500-1519",
"FirstLinePracticeLocationAddress": "501 W GLENOAKS BLVD STE 12",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GLENDALE",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91202-4041",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "818-500-1517",
"PracticeLocationAddressFaxNumber": "818-500-1519",
"EnumerationDate": "01/24/2014",
"LastUpdateDate": "10/23/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GHANEKAR",
"AuthorizedOfficialFirstName": "AVINASH",
"AuthorizedOfficialMiddleName": "GOVIND",
"AuthorizedOfficialTitle": "MANAGER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "818-500-2517",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": "PHY51730",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}