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1629129143 NPI number — GINA DANESH D.O.

NPI Number: 1629129143
Health Care Provider/Practitioner: GINA DANESH D.O.

Information about “1629129143” NPI (GINA DANESH D.O.) exists in 1629129143 in HTML format HTML  |  1629129143 in plain Text format TXT  |  1629129143 in PDF (Portable Document Format) PDF  |  1629129143 in an XML format XML  formats.

NPI Number : 1629129143 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1629129143",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DANESH",
    "FirstName": "GINA",
    "MiddleName": null,
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "D.O.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1158 26TH ST",
    "SecondLineMailingAddress": "449",
    "MailingAddressCityName": "SANTA MONICA",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "90403-4621",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "213-742-7777",
    "MailingAddressFaxNumber": "213-742-0808",
    "FirstLinePracticeLocationAddress": "1740 S LOS ANGELES ST",
    "SecondLinePracticeLocationAddress": "105",
    "PracticeLocationAddressCityName": "LOS ANGELES",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "90015-3632",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "213-742-7777",
    "PracticeLocationAddressFaxNumber": "213-742-0808",
    "EnumerationDate": "01/12/2007",
    "LastUpdateDate": "07/08/2007",
    "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": "208D00000X",
        "TaxonomyName": "General Practice Physician",
        "LicenseNumber": "20A8286",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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