{
"Npi": {
"NPI": "1659513901",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "ALLIANCE MEDICAL CORPORATION",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1009 OAK HILL RD FL 3",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LAFAYETTE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "94549-3869",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "925-299-8000",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1009 OAK HILL RD FL 3",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LAFAYETTE",
"PracticeLocationAddressStateName": "CA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "925-299-8000",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/01/2009",
"LastUpdateDate": "04/01/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FESS",
"AuthorizedOfficialFirstName": "EDWARD",
"AuthorizedOfficialMiddleName": "G",
"AuthorizedOfficialTitle": "CEO/PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "925-299-8000",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QU0200X",
"TaxonomyName": "Urgent Care Clinic/Center",
"LicenseNumber": "C39876",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}