{
"Npi": {
"NPI": "1669533642",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MASSEN MEDICAL INC.",
"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": "19682 HESPERIAN BLVD STE 101A",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HAYWARD",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "94541-4752",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "510-783-0536",
"MailingAddressFaxNumber": "510-315-1103",
"FirstLinePracticeLocationAddress": "19682 HESPERIAN BLVD",
"SecondLinePracticeLocationAddress": "STE 101A",
"PracticeLocationAddressCityName": "HAYWARD",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "94541-4752",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "510-783-0536",
"PracticeLocationAddressFaxNumber": "510-315-1103",
"EnumerationDate": "12/13/2006",
"LastUpdateDate": "12/18/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MASSEN",
"AuthorizedOfficialFirstName": "ARKADY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "MEDICAL DOCTOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "510-783-0536",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": "00A527260",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}