{
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"IsOrgSubpart": "Y",
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherCredential": null,
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"FirstLineMailingAddress": "1525 POST ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAN FRANCISCO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "94109-6567",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "415-202-7800",
"MailingAddressFaxNumber": "415-922-2338",
"FirstLinePracticeLocationAddress": "501 VIA CASITAS",
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"PracticeLocationAddressCityName": "GREENBRAE",
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"PracticeLocationAddressPostalCode": "94904-1958",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "415-461-2300",
"PracticeLocationAddressFaxNumber": "415-461-0241",
"EnumerationDate": "07/03/2006",
"LastUpdateDate": "02/07/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BOYD",
"AuthorizedOfficialFirstName": "MI NAN",
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"AuthorizedOfficialTitle": "CFO",
"AuthorizedOfficialNamePrefix": "MS.",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "415-202-7814",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "314000000X",
"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": "010000376",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}