{
"Npi": {
"NPI": "1356410351",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PRIME HEALTHCARE PARADISE VALLEY LLC",
"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": "3480 E GUASTI RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ONTARIO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91761-7684",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "909-235-4400",
"MailingAddressFaxNumber": "909-235-4316",
"FirstLinePracticeLocationAddress": "2400 E 4TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NATIONAL CITY",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91950-2026",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "619-470-4321",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/06/2006",
"LastUpdateDate": "04/14/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DOAN",
"AuthorizedOfficialFirstName": "CHRISTOPHER",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "MANAGING ASSOCIATE GENERAL COUNSEL",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "310-259-4706",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "282N00000X",
"TaxonomyName": "General Acute Care Hospital",
"LicenseNumber": "090000086",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}