{
"Npi": {
"NPI": "1801955992",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SAN FRANCISCO MED. CLINIC FOR THE TREATMENT OF PAIN, P.C.",
"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": "1790 26TH AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAN FRANCISCO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "94122-4316",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "415-731-1330",
"MailingAddressFaxNumber": "415-566-1066",
"FirstLinePracticeLocationAddress": "1790 26TH AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAN FRANCISCO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "94122-4316",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "415-731-1330",
"PracticeLocationAddressFaxNumber": "415-566-1066",
"EnumerationDate": "12/06/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LEE",
"AuthorizedOfficialFirstName": "TSUN-NIN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DIRECTOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "415-731-1330",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM1300X",
"TaxonomyName": "Multi-Specialty Clinic/Center",
"LicenseNumber": "G20668",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}