{
"Npi": {
"NPI": "1578695227",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "DARDASHTI",
"FirstName": "ROBERT",
"MiddleName": "ELIA",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "D.C,",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "24332 SAN FERNANDO RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NEWHALL",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91321-2913",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "661-222-7575",
"MailingAddressFaxNumber": "661-222-7872",
"FirstLinePracticeLocationAddress": "16661 VENTURA BLVD",
"SecondLinePracticeLocationAddress": "SUITE 115",
"PracticeLocationAddressCityName": "ENCINO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91436-1914",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "818-789-5560",
"PracticeLocationAddressFaxNumber": "818-789-7025",
"EnumerationDate": "03/09/2007",
"LastUpdateDate": "02/27/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "DC20870",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "111NR0400X",
"TaxonomyName": "Rehabilitation Chiropractor",
"LicenseNumber": "DC20870",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}