{
"Npi": {
"NPI": "1629341060",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DAVID J GAJDA MD A PROFESSIONAL CORPORATION",
"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": "6283 CLARK RD",
"SecondLineMailingAddress": "SUITE #10",
"MailingAddressCityName": "PARADISE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95969-4100",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "530-877-2020",
"MailingAddressFaxNumber": "530-877-4641",
"FirstLinePracticeLocationAddress": "111 RALEY BLVD",
"SecondLinePracticeLocationAddress": "# 240",
"PracticeLocationAddressCityName": "CHICO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "95928-8351",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "530-892-2020",
"PracticeLocationAddressFaxNumber": "530-898-9614",
"EnumerationDate": "02/15/2012",
"LastUpdateDate": "02/20/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GAJDA",
"AuthorizedOfficialFirstName": "DAVID",
"AuthorizedOfficialMiddleName": "JEFFERY",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "530-877-2020",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332H00000X",
"TaxonomyName": "Eyewear Supplier",
"LicenseNumber": "G88865",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}