{
"Npi": {
"NPI": "1497135768",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "EYE SURGICAL MEDICAL GROUP OF SANTA BARBARA, INC.",
"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": "533 E. MICHELTORENA ST.",
"SecondLineMailingAddress": "SUITE 103",
"MailingAddressCityName": "SANTA BARBARA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "93103-2206",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "805-564-8917",
"MailingAddressFaxNumber": "805-564-8915",
"FirstLinePracticeLocationAddress": "533 E MICHELTORENA ST",
"SecondLinePracticeLocationAddress": "SUITE 103",
"PracticeLocationAddressCityName": "SANTA BARBARA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "93103-2200",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "805-564-8917",
"PracticeLocationAddressFaxNumber": "805-564-8915",
"EnumerationDate": "06/02/2015",
"LastUpdateDate": "06/02/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "COULTER",
"AuthorizedOfficialFirstName": "WILLIAM",
"AuthorizedOfficialMiddleName": "HAROLD",
"AuthorizedOfficialTitle": "PRESIDENT / OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "805-564-8917",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "282N00000X",
"TaxonomyName": "General Acute Care Hospital",
"LicenseNumber": "C29906",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}