{
"Npi": {
"NPI": "1225214554",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GLENN R. IRANI, M.D. AND KRISTINE KERN IRANI, M.D., INC.",
"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": "5525 ETIWANDA AVE",
"SecondLineMailingAddress": "SUITE 212",
"MailingAddressCityName": "TARZANA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91356-3647",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "818-344-7600",
"MailingAddressFaxNumber": "818-996-9709",
"FirstLinePracticeLocationAddress": "5525 ETIWANDA AVE",
"SecondLinePracticeLocationAddress": "SUITE 212",
"PracticeLocationAddressCityName": "TARZANA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91356-3647",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "818-344-7600",
"PracticeLocationAddressFaxNumber": "818-996-9709",
"EnumerationDate": "01/16/2008",
"LastUpdateDate": "01/16/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "IRANI, M.D.",
"AuthorizedOfficialFirstName": "GLENN",
"AuthorizedOfficialMiddleName": "R.",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "818-344-7600",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "208000000X",
"TaxonomyName": "Pediatrics Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}