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"FirstLineMailingAddress": "18225 US HIGHWAY 18",
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"MailingAddressCityName": "APPLE VALLEY",
"MailingAddressStateName": "CA",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "951-479-2915",
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"FirstLinePracticeLocationAddress": "18225 OUTER HWY 18",
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"PracticeLocationAddressCityName": "APPLE VALLEY",
"PracticeLocationAddressStateName": "CA",
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"PracticeLocationAddressTelephoneNumber": "760-242-4199",
"PracticeLocationAddressFaxNumber": "760-242-3814",
"EnumerationDate": "11/02/2018",
"LastUpdateDate": "10/27/2021",
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MORRISON",
"AuthorizedOfficialFirstName": "NORRIS",
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"AuthorizedOfficialTitle": "MEDICAL DIRECTOR /OWNER",
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"AuthorizedOfficialCredential": "DPM",
"AuthorizedOfficialTelephoneNumber": "909-635-4072",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "213ES0103X",
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},
{
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}
]
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}