{
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"ReplacementNPI": null,
"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HUNTINGTON BEACH FAMILY MEDICINE, INC",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "19400 BEACH BLVD",
"SecondLineMailingAddress": "#11",
"MailingAddressCityName": "HUNTINGTON BEACH",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92648-2500",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "714-968-1222",
"MailingAddressFaxNumber": "714-968-1777",
"FirstLinePracticeLocationAddress": "19400 BEACH BLVD",
"SecondLinePracticeLocationAddress": "#11",
"PracticeLocationAddressCityName": "HUNTINGTON BEACH",
"PracticeLocationAddressStateName": "CA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "714-968-1222",
"PracticeLocationAddressFaxNumber": "714-968-1777",
"EnumerationDate": "05/22/2014",
"LastUpdateDate": "10/28/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "THOMAS",
"AuthorizedOfficialFirstName": "NATASHA",
"AuthorizedOfficialMiddleName": "G",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "714-968-1222",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": "A115473",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}