{
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"FirstLineMailingAddress": "525 W. ACACIA STREET",
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"MailingAddressPostalCode": "95203-2484",
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"MailingAddressTelephoneNumber": "209-461-3148",
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"FirstLinePracticeLocationAddress": "530 W ACACIA ST",
"SecondLinePracticeLocationAddress": "SUITE 1",
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"PracticeLocationAddressTelephoneNumber": "209-944-5410",
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"EnumerationDate": "04/23/2014",
"LastUpdateDate": "04/24/2014",
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"NPIReactivationDate": null,
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"AuthorizedOfficialLastName": "AUERBACH",
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"AuthorizedOfficialTelephoneNumber": "209-461-3100",
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}
},
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}
}