{
"Npi": {
"NPI": "1477329811",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MAYHEM UNITY LIMITED LIABILTY COMPANY",
"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": "273 GATEWAY DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PACIFICA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "94044-1246",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "275 GATEWAY DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PACIFICA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "94044-1247",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "415-910-3036",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/28/2023",
"LastUpdateDate": "01/19/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PULATHUJAYEV",
"AuthorizedOfficialFirstName": "SULTONHON",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "MANAGER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "415-910-3036",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "342000000X",
"TaxonomyName": "Transportation Network Company",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}