{
"Npi": {
"NPI": "1619279361",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PQ OUTREACH COALITION",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "10060 CARMEL MOUNTAIN RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAN DIEGO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92129-3228",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "858-206-1860",
"MailingAddressFaxNumber": "858-484-8577",
"FirstLinePracticeLocationAddress": "10060 CARMEL MOUNTAIN RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAN DIEGO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92129-3228",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "858-206-1860",
"PracticeLocationAddressFaxNumber": "858-484-8577",
"EnumerationDate": "12/01/2010",
"LastUpdateDate": "12/01/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HARMANING",
"AuthorizedOfficialFirstName": "WILLIAM",
"AuthorizedOfficialMiddleName": "KENNETH",
"AuthorizedOfficialTitle": "CHAIR BOARD OF DIRECTORS",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "ED.D.",
"AuthorizedOfficialTelephoneNumber": "858-206-1860",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "305S00000X",
"TaxonomyName": "Point of Service",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}