{
"Npi": {
"NPI": "1730608423",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "E.V.A. HEALTH LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherLastName": null,
"OtherFirstName": null,
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"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "15869 AMAR RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LA PUNTE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91744",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "626-261-4400",
"MailingAddressFaxNumber": "626-261-4948",
"FirstLinePracticeLocationAddress": "15869 AMAR RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LA PUNTE",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91744",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "626-261-4400",
"PracticeLocationAddressFaxNumber": "626-261-4948",
"EnumerationDate": "09/13/2017",
"LastUpdateDate": "06/30/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NOUR",
"AuthorizedOfficialFirstName": "CHADI",
"AuthorizedOfficialMiddleName": "ABDUL",
"AuthorizedOfficialTitle": "MEMBER/PIC",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "626-261-4400",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "55516",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}