{
"Npi": {
"NPI": "1568481679",
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LUIS A CHANES M D INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2621 S BRISTOL ST",
"SecondLineMailingAddress": "SUITE 205",
"MailingAddressCityName": "SANTA ANA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92704-5766",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "714-557-5777",
"MailingAddressFaxNumber": "714-557-7710",
"FirstLinePracticeLocationAddress": "2621 S BRISTOL ST",
"SecondLinePracticeLocationAddress": "SUITE 205",
"PracticeLocationAddressCityName": "SANTA ANA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92704-5766",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "714-557-5777",
"PracticeLocationAddressFaxNumber": "714-557-7710",
"EnumerationDate": "07/19/2006",
"LastUpdateDate": "01/18/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CHANES",
"AuthorizedOfficialFirstName": "LUIS",
"AuthorizedOfficialMiddleName": "ALBERTO",
"AuthorizedOfficialTitle": "OWNER/PHYSICIAN",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "714-557-5777",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "174400000X",
"TaxonomyName": "Specialist",
"LicenseNumber": "G73198",
"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."
}
}
}
}