{
"Npi": {
"NPI": "1720035561",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GRASS VALLEY HEMATOLOGY/ONCOLOGY MED GRP",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 1549",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GRASS VALLEY",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95945-1549",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "530-274-6677",
"MailingAddressFaxNumber": "530-274-6678",
"FirstLinePracticeLocationAddress": "155 GLASSON WAY",
"SecondLinePracticeLocationAddress": "SUITE L10",
"PracticeLocationAddressCityName": "GRASS VALLEY",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "95945-5723",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "530-274-6677",
"PracticeLocationAddressFaxNumber": "530-274-6678",
"EnumerationDate": "05/27/2006",
"LastUpdateDate": "08/26/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CAMPBELL",
"AuthorizedOfficialFirstName": "DAVID",
"AuthorizedOfficialMiddleName": "LAWRENCE",
"AuthorizedOfficialTitle": "PARTNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "530-274-6677",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207RH0003X",
"TaxonomyName": "Hematology & Oncology Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}