{
"Npi": {
"NPI": "1700921103",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BECK",
"FirstName": "PAUL",
"MiddleName": "V.",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "M.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1555 EAST ST STE 220",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "REDDING",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "96001-1153",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "530-246-1240",
"MailingAddressFaxNumber": "402-434-6047",
"FirstLinePracticeLocationAddress": "1555 EAST ST",
"SecondLinePracticeLocationAddress": "SUITE 220",
"PracticeLocationAddressCityName": "REDDING",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "96001-1153",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "530-246-1240",
"PracticeLocationAddressFaxNumber": "530-247-8202",
"EnumerationDate": "02/21/2007",
"LastUpdateDate": "01/19/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "208600000X",
"TaxonomyName": "Surgery Physician",
"LicenseNumber": "A120629",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "2086S0127X",
"TaxonomyName": "Trauma Surgery Physician",
"LicenseNumber": "A120629",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}