NPI Code Detail JSON Logo

1487667002 NPI number — CARL LAURYSSEN MD PROF CORP.

NPI Number: 1487667002
Health Care Provider/Practitioner: CARL LAURYSSEN MD PROF CORP.

Information about “1487667002” NPI (CARL LAURYSSEN MD PROF CORP.) exists in 1487667002 in HTML format HTML  |  1487667002 in plain Text format TXT  |  1487667002 in PDF (Portable Document Format) PDF  |  1487667002 in an XML format XML  formats.

NPI Number : 1487667002 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1487667002",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "CARL LAURYSSEN MD PROF CORP.",
    "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": "8201 BEVERLY BLVD",
    "SecondLineMailingAddress": "SUITE 405",
    "MailingAddressCityName": "LOS ANGELES",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "90048-4505",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "8201 BEVERLY BLVD STE 405",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LOS ANGELES",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "90048-4505",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "323-272-4678",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/14/2006",
    "LastUpdateDate": "02/19/2014",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "LAURYSSEN",
    "AuthorizedOfficialFirstName": "CARL",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "M.D.",
    "AuthorizedOfficialTelephoneNumber": "310-358-2490",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "261QM2500X",
          "TaxonomyName": "Medical Specialty Clinic/Center",
          "LicenseNumber": "C50914",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207T00000X",
          "TaxonomyName": "Neurological Surgery Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "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."
      }
    }
  }
}
                
            

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