{
"Npi": {
"NPI": "1609118983",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "SALAM F ALKASSPOOLES M D AMC",
"ParentOrgTIN": null,
"OrgName": "SALAM F ALKASSPOOLES M D AMC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "11633 SAN VICENTE BLVD STE 314",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LOS ANGELES",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90049-6514",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "310-207-0020",
"MailingAddressFaxNumber": "310-207-0030",
"FirstLinePracticeLocationAddress": "11633 SAN VICENTE BLVD",
"SecondLinePracticeLocationAddress": "SUITE 314",
"PracticeLocationAddressCityName": "LOS ANGELES",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90049-6511",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "310-207-0020",
"PracticeLocationAddressFaxNumber": "310-207-0030",
"EnumerationDate": "03/25/2013",
"LastUpdateDate": "01/24/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ALKASSPOOLES",
"AuthorizedOfficialFirstName": "SALAM",
"AuthorizedOfficialMiddleName": "F",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "310-652-0092",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}