{
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"OrgName": "WELL CARE MEDICAL CENTER INC.",
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"FirstLineMailingAddress": "8549 WILSHIRE BLVD STE 1149",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BEVERLY HILLS",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90211-3104",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "714-654-7990",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "8780 VAN NUYS BLVD STE B",
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"PracticeLocationAddressCityName": "PANORAMA CITY",
"PracticeLocationAddressStateName": "CA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "818-894-3111",
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"EnumerationDate": "08/13/2018",
"LastUpdateDate": "08/13/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ARMANIOUS",
"AuthorizedOfficialFirstName": "NADER",
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"AuthorizedOfficialTitle": "CEO",
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"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "714-654-7990",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Specialist",
"LicenseNumber": "A72796",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}