{
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"FirstLineMailingAddress": "19275 SAN MARCOS RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SARATOGA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95070-5677",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "650-766-8718",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2464 W EL CAMINO REAL STE B",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MOUNTAIN VIEW",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "94040-1425",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "650-766-8718",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/31/2020",
"LastUpdateDate": "08/09/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LI",
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"AuthorizedOfficialTitle": "DOCTOR AND OWNER",
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"AuthorizedOfficialCredential": "OMD",
"AuthorizedOfficialTelephoneNumber": "650-772-2568",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Health Service Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}