{
"Npi": {
"NPI": "1245473677",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MARK C. ROTHMAN, M. D., INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "371 VAN NESS WAY STE 210",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TORRANCE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90501-6297",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "310-792-3914",
"MailingAddressFaxNumber": "855-503-4977",
"FirstLinePracticeLocationAddress": "436 N BEDFORD DR STE 102",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BEVERLY HILLS",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90210-4323",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "310-385-8819",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/15/2009",
"LastUpdateDate": "08/26/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ROTHMAN",
"AuthorizedOfficialFirstName": "MARK",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT/ SOLE OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "818-244-8200",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "207LP2900X",
"TaxonomyName": "Pain Medicine (Anesthesiology) Physician",
"LicenseNumber": "G83051",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207L00000X",
"TaxonomyName": "Anesthesiology Physician",
"LicenseNumber": "G83051",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": [
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
]
}
}
}