{
"Npi": {
"NPI": "1255881074",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CVS",
"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": "1512 PROSPECT AVE",
"SecondLineMailingAddress": "UNIT D",
"MailingAddressCityName": "SAN GABRIEL",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91776-4422",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1512 PROSPECT AVE APT D",
"SecondLinePracticeLocationAddress": "D",
"PracticeLocationAddressCityName": "SAN GABRIEL",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91776-4422",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "626-823-1189",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/05/2016",
"LastUpdateDate": "10/05/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SEK",
"AuthorizedOfficialFirstName": "GRACE",
"AuthorizedOfficialMiddleName": "LING",
"AuthorizedOfficialTitle": "PHARMACIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARM.D.",
"AuthorizedOfficialTelephoneNumber": "626-823-1189",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "282N00000X",
"TaxonomyName": "General Acute Care Hospital",
"LicenseNumber": "75281",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}