{
"Npi": {
"NPI": "1770801516",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PACIFIC WOMEN'S HEALTH CLINIC, INC",
"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": "2495 HOSPITAL DR STE 505",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MOUNTAIN VIEW",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "94040-4157",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "877-376-2496",
"MailingAddressFaxNumber": "888-650-6564",
"FirstLinePracticeLocationAddress": "2495 HOSPITAL DR STE 505",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MOUNTAIN VIEW",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "94040-4157",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "877-376-2496",
"PracticeLocationAddressFaxNumber": "888-650-6564",
"EnumerationDate": "05/04/2010",
"LastUpdateDate": "10/01/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MHAMUNKAR",
"AuthorizedOfficialFirstName": "VIDYA",
"AuthorizedOfficialMiddleName": "NITIN",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "877-376-2496",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM2500X",
"TaxonomyName": "Medical Specialty Clinic/Center",
"LicenseNumber": "A105976",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}