{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
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"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1132 CADILLAC CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MILPITAS",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95035-3058",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "408-935-9120",
"MailingAddressFaxNumber": "408-935-9121",
"FirstLinePracticeLocationAddress": "1132 CADILLAC CT",
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"PracticeLocationAddressCityName": "MILPITAS",
"PracticeLocationAddressStateName": "CA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "408-935-9120",
"PracticeLocationAddressFaxNumber": "408-935-9121",
"EnumerationDate": "06/20/2008",
"LastUpdateDate": "08/26/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BASRAI",
"AuthorizedOfficialFirstName": "MIRANDA",
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"AuthorizedOfficialTitle": "PHARMACIST",
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"AuthorizedOfficialCredential": "PHARM. D",
"AuthorizedOfficialTelephoneNumber": "510-366-9218",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "PHY49020",
"LicenseNumberStateCode": "CA",
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},
{
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},
{
"TaxonomyCode": "3336L0003X",
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"LicenseNumber": null,
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}