{
"Npi": {
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "YIN-JIA GONG MEDICAL CORPORATION",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherOrgNameTypeCode": "6",
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "112 N RIVERSIDE AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RIALTO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92376-5922",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "909-875-1212",
"MailingAddressFaxNumber": "909-498-7361",
"FirstLinePracticeLocationAddress": "112 N RIVERSIDE AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "RIALTO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92376-5922",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "909-875-1212",
"PracticeLocationAddressFaxNumber": "909-498-7361",
"EnumerationDate": "11/26/2007",
"LastUpdateDate": "08/17/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GONG",
"AuthorizedOfficialFirstName": "YIN-JIA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "909-875-1212",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP3300X",
"TaxonomyName": "Pain Clinic/Center",
"LicenseNumber": "A56519",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}