{
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"FirstLineMailingAddress": "2638 EDITH AVE",
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"MailingAddressStateName": "CA",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "2638 EDITH AVE",
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"PracticeLocationAddressFaxNumber": "530-244-4185",
"EnumerationDate": "02/12/2007",
"LastUpdateDate": "09/08/2022",
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "DITCHEY",
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"Taxonomies": {
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"TaxonomyName": "Cardiovascular Disease Physician",
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"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}