{
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"FirstLineMailingAddress": "2626 GRAPEVINE TER",
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"MailingAddressCityName": "FREMONT",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "94539-6079",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "510-648-2626",
"MailingAddressFaxNumber": "866-383-0295",
"FirstLinePracticeLocationAddress": "39141 CIVIC CENTER DR",
"SecondLinePracticeLocationAddress": "SUITE 110",
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"EnumerationDate": "05/31/2009",
"LastUpdateDate": "05/31/2009",
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"NPIReactivationDate": null,
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"AuthorizedOfficialLastName": "KILARU",
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"AuthorizedOfficialCredential": "M.D.",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "208200000X",
"TaxonomyName": "Plastic Surgery Physician",
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"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}
}
}