{
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"FirstLineMailingAddress": "343 E PALMDALE BLVD STE 5B",
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"FirstLinePracticeLocationAddress": "1429 E THOUSAND OAKS BLVD STE 210",
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"EnumerationDate": "05/15/2007",
"LastUpdateDate": "08/22/2020",
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"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TARAZI",
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"Taxonomies": {
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}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}