{
"Npi": {
"NPI": "1649700618",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "CAMARENA HEALTH",
"ParentOrgTIN": null,
"OrgName": "CAMARENA HEALTH",
"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": "PO BOX 299",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MADERA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "93639-0299",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "559-664-4000",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "740 E ALMOND AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MADERA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "93637-5617",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "559-664-4000",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/13/2017",
"LastUpdateDate": "01/18/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SOARES",
"AuthorizedOfficialFirstName": "PAULO",
"AuthorizedOfficialMiddleName": "A.",
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "559-664-4000",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207VX0000X",
"TaxonomyName": "Obstetrics Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}