NPI Code Detail JSON Logo

1427101369 NPI number — BENACARE MEDICAL CENTER, INC

NPI Number: 1427101369
Health Care Provider/Practitioner: BENACARE MEDICAL CENTER, INC

Information about “1427101369” NPI (BENACARE MEDICAL CENTER, INC) exists in 1427101369 in HTML format HTML  |  1427101369 in plain Text format TXT  |  1427101369 in PDF (Portable Document Format) PDF  |  1427101369 in an XML format XML  formats.

NPI Number : 1427101369 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1427101369",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "BENACARE MEDICAL CENTER, INC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "984 W FOOTHILL BLVD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "UPLAND",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "91786-3700",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "909-373-8222",
    "MailingAddressFaxNumber": "877-803-0308",
    "FirstLinePracticeLocationAddress": "984 W FOOTHILL BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "UPLAND",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "91786-3700",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "909-373-8222",
    "PracticeLocationAddressFaxNumber": "877-803-0308",
    "EnumerationDate": "01/22/2007",
    "LastUpdateDate": "04/02/2014",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "BENAVIDEZ",
    "AuthorizedOfficialFirstName": "MELINDA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "ADMINISTRATOR",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "909-373-8222",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": "20A8664",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": "20A6396",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        }
      ]
    }
  }
}
                
            

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