{
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"EIN": null,
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"OrgName": "THOMAS G HIROSE, M.D. APC LABORATORY",
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"FirstLineMailingAddress": "647 CAMINO DE LOS MARES",
"SecondLineMailingAddress": "SUITE 223",
"MailingAddressCityName": "SAN CLEMENTE",
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"MailingAddressPostalCode": "92673-2807",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "949-487-5100",
"MailingAddressFaxNumber": "949-487-7065",
"FirstLinePracticeLocationAddress": "647 CAMINO DE LOS MARES",
"SecondLinePracticeLocationAddress": "SUITE 223",
"PracticeLocationAddressCityName": "SAN CLEMENTE",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "949-487-5100",
"PracticeLocationAddressFaxNumber": "949-487-7065",
"EnumerationDate": "08/27/2009",
"LastUpdateDate": "08/27/2009",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HIROSE",
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"AuthorizedOfficialCredential": "M.D,",
"AuthorizedOfficialTelephoneNumber": "949-487-5100",
"Taxonomies": {
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"TaxonomyName": "Clinical Medical Laboratory",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}