{
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "CHIROPRACTIC HEALTH PLAN OF CALIFORNIA, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherOrgNameTypeCode": null,
"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 190",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CLAYTON",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "94517-0190",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "925-844-3100",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "5356 CLAYTON RD STE 201",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CONCORD",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "94521-3200",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "925-844-3100",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/13/2009",
"LastUpdateDate": "07/13/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CATALDO",
"AuthorizedOfficialFirstName": "TODD",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "VICE PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "925-844-3100",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "302F00000X",
"TaxonomyName": "Exclusive Provider Organization",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "305R00000X",
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}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}