{
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"FirstLineMailingAddress": "9720 MAGNOLIA AVE SUITE 100",
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"MailingAddressTelephoneNumber": "951-696-3663",
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"FirstLinePracticeLocationAddress": "9720 MAGNOLIA AVE SUITE #100",
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"EnumerationDate": "08/27/2015",
"LastUpdateDate": "01/03/2020",
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GERONIMO",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}