{
"Npi": {
"NPI": "1295824118",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ABJ SURGERY CENTER, 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": "11999 SAN VICENTE BLVD",
"SecondLineMailingAddress": "STE. 440",
"MailingAddressCityName": "LOS ANGELES",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90049-5131",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "310-440-3131",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "104 SAINT MATTHEWS AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAN MATEO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "94401-2807",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "650-348-8600",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/11/2006",
"LastUpdateDate": "04/21/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PERTSCH",
"AuthorizedOfficialFirstName": "JAMES",
"AuthorizedOfficialMiddleName": "L.",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "650-348-8600",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QA1903X",
"TaxonomyName": "Ambulatory Surgical Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}