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1568647022 NPI number — JILL HOLLY JAVAHERY M.D.

NPI Number: 1568647022
Health Care Provider/Practitioner: JILL HOLLY JAVAHERY M.D.

Information about “1568647022” NPI (JILL HOLLY JAVAHERY M.D.) exists in 1568647022 in HTML format HTML  |  1568647022 in plain Text format TXT  |  1568647022 in PDF (Portable Document Format) PDF  |  1568647022 in an XML format XML  formats.

NPI Number : 1568647022 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1568647022",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "JAVAHERY",
    "FirstName": "JILL",
    "MiddleName": "HOLLY",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3918 LONG BEACH BLVD STE 200",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LONG BEACH",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "90807-2685",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "562-997-1144",
    "MailingAddressFaxNumber": "562-997-9881",
    "FirstLinePracticeLocationAddress": "3918 LONG BEACH BLVD STE 200",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LONG BEACH",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "90807-2685",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "562-997-1144",
    "PracticeLocationAddressFaxNumber": "562-997-9881",
    "EnumerationDate": "01/03/2008",
    "LastUpdateDate": "01/03/2008",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "174400000X",
        "TaxonomyName": "Specialist",
        "LicenseNumber": "A99753",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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