{
"Npi": {
"NPI": "1467730689",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "AUNG",
"FirstName": "GREGORY",
"MiddleName": "LEE",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "PHARMD.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "11201 BENTON ST # 119",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LOMA LINDA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92357-1000",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "909-825-7084",
"MailingAddressFaxNumber": "909-777-3810",
"FirstLinePracticeLocationAddress": "3350 LA JOLLA VILLAGE DR",
"SecondLinePracticeLocationAddress": "PHARMACY SERVICE (119)",
"PracticeLocationAddressCityName": "SAN DIEGO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92161-0002",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "858-642-3026",
"PracticeLocationAddressFaxNumber": "858-552-7582",
"EnumerationDate": "07/22/2011",
"LastUpdateDate": "11/13/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1835I0206X",
"TaxonomyName": "Infectious Diseases Pharmacist",
"LicenseNumber": "64628",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X 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."
}
}
}
}