{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "ORANGE COUNTY URGENT CARE #3 INC.",
"LastName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "115 EASTPARK DR STE 300",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BRENTWOOD",
"MailingAddressStateName": "TN",
"MailingAddressPostalCode": "37027-2311",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "615-600-4074",
"MailingAddressFaxNumber": "615-309-8341",
"FirstLinePracticeLocationAddress": "7330 EL CAMINO REAL",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ATASCADERO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "93442",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "805-703-2501",
"PracticeLocationAddressFaxNumber": "805-703-2502",
"EnumerationDate": "12/05/2017",
"LastUpdateDate": "01/12/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ENDERLE",
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"AuthorizedOfficialTitle": "AUTHORIZED SIGNATORY",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "615-600-4120",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QU0200X",
"TaxonomyName": "Urgent Care Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}