{
"Npi": {
"NPI": "1255584678",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NORMAN A. ROSE, OD,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": "1299 E PENNSYLVANIA AVE",
"SecondLineMailingAddress": "SUITE B",
"MailingAddressCityName": "ESCONDIDO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92027-3027",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "760-743-6540",
"MailingAddressFaxNumber": "760-743-4164",
"FirstLinePracticeLocationAddress": "41593 WINCHESTER RD STE 200",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "TEMECULA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92590-4857",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "760-743-6540",
"PracticeLocationAddressFaxNumber": "760-743-4164",
"EnumerationDate": "10/29/2008",
"LastUpdateDate": "05/27/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ROSE",
"AuthorizedOfficialFirstName": "NORMAN",
"AuthorizedOfficialMiddleName": "A",
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "O.D.",
"AuthorizedOfficialTelephoneNumber": "760-533-4541",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "152WL0500X",
"TaxonomyName": "Low Vision Rehabilitation Optometrist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"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."
}
}
}
}