{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "PROSPICE PHYSICAL MEDICINE CENTERS",
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"FirstLineMailingAddress": "5630 E SANTA ANA CANYON RD",
"SecondLineMailingAddress": "STE. 150",
"MailingAddressCityName": "ANAHEIM",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92807-3126",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "714-476-2073",
"MailingAddressFaxNumber": "951-537-6931",
"FirstLinePracticeLocationAddress": "5630 E SANTA ANA CANYON RD",
"SecondLinePracticeLocationAddress": "STE. 150",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "714-476-2073",
"PracticeLocationAddressFaxNumber": "951-537-6931",
"EnumerationDate": "02/13/2012",
"LastUpdateDate": "03/13/2012",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SINGH",
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"AuthorizedOfficialTitle": "MEDICAL DIRECTOR",
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"AuthorizedOfficialCredential": "M.D.",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Multi-Specialty Clinic/Center",
"LicenseNumber": "C3420564",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}