{
"Npi": {
"NPI": "1336146935",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DREYFUS ENTERPRISES",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "23665 MOULTON PKWY",
"SecondLineMailingAddress": "STE A",
"MailingAddressCityName": "LAGUNA HILLS",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92653-1937",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "949-768-5700",
"MailingAddressFaxNumber": "949-768-1359",
"FirstLinePracticeLocationAddress": "23665 MOULTON PKWY",
"SecondLinePracticeLocationAddress": "STE A",
"PracticeLocationAddressCityName": "LAGUNA HILLS",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92653-1937",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "949-768-5700",
"PracticeLocationAddressFaxNumber": "949-768-1359",
"EnumerationDate": "06/28/2005",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DREYFUS",
"AuthorizedOfficialFirstName": "GARY",
"AuthorizedOfficialMiddleName": "A",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "949-768-5700",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": "819437",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}