{
"Npi": {
"NPI": "1659788578",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SIMRIN GILL",
"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": "2600 MITCHELL RD",
"SecondLineMailingAddress": "STE G",
"MailingAddressCityName": "CERES",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95307-9468",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "209-585-4500",
"MailingAddressFaxNumber": "209-320-3513",
"FirstLinePracticeLocationAddress": "2600 MITCHELL RD STE G",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CERES",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "95307-9466",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "209-585-4500",
"PracticeLocationAddressFaxNumber": "209-320-3513",
"EnumerationDate": "07/14/2014",
"LastUpdateDate": "09/20/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GILL",
"AuthorizedOfficialFirstName": "SIMRIN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/ CASHIER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "209-604-5533",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "51923",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}