{
"Npi": {
"NPI": "1770768814",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GK URGI CARE, INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
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"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1695 S. SAN JACINTO",
"SecondLineMailingAddress": "SUITE A",
"MailingAddressCityName": "SAN JACINTO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92583-0000",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "951-665-1100",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1695 S. SAN JACINTO",
"SecondLinePracticeLocationAddress": "SUITE A",
"PracticeLocationAddressCityName": "SAN JACINTO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92583-0000",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "951-665-1100",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/08/2008",
"LastUpdateDate": "02/21/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KOKA",
"AuthorizedOfficialFirstName": "VIDHYA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "SHARED OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "951-665-1100",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": "A60821",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}