{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "PERRY B. SHEIDAYI, D.O., PROFESSIONAL CORPORATION",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
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"FirstLineMailingAddress": "18 ENDEAVOR STE 201",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "IRVINE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92618-3181",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "949-650-5771",
"MailingAddressFaxNumber": "949-340-3967",
"FirstLinePracticeLocationAddress": "18 ENDEAVOR STE 201",
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"PracticeLocationAddressCityName": "IRVINE",
"PracticeLocationAddressStateName": "CA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "949-650-5771",
"PracticeLocationAddressFaxNumber": "949-340-3967",
"EnumerationDate": "08/31/2006",
"LastUpdateDate": "02/18/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SHEIDAYI",
"AuthorizedOfficialFirstName": "PERRY",
"AuthorizedOfficialMiddleName": "BEHROOZ",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": "D.O.",
"AuthorizedOfficialTelephoneNumber": "949-650-5771",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207Q00000X",
"TaxonomyName": "Family Medicine Physician",
"LicenseNumber": "20A7800",
"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."
}
}
}
}