1396917332 NPI number — CHIA C PORTERA M.D., PH.D.

NPI Number: 1396917332
Health Care Provider/Practitioner: CHIA C PORTERA M.D., PH.D.

NPI Number : 1396917332 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1396917332",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PORTERA",
    "FirstName": "CHIA",
    "MiddleName": "C",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "M.D., PH.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "CHIAO",
    "OtherFirstName": "CHIA",
    "OtherMiddleName": null,
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "BUILDING 10 RM12N226",
    "SecondLineMailingAddress": "10 CENTER DR.",
    "MailingAddressCityName": "BETHESDA",
    "MailingAddressStateName": "MD",
    "MailingAddressPostalCode": "20892-0001",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "301-496-3986",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "BUILDING 10 RM12N226",
    "SecondLinePracticeLocationAddress": "10 CENTER DR.",
    "PracticeLocationAddressCityName": "BETHESDA",
    "PracticeLocationAddressStateName": "MD",
    "PracticeLocationAddressPostalCode": "20892-0001",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "301-496-3986",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/31/2008",
    "LastUpdateDate": "03/31/2008",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "284300000X",
        "TaxonomyName": "Special Hospital",
        "LicenseNumber": "D0063372",
        "LicenseNumberStateCode": "MD",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}