{
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"FirstLineMailingAddress": "11815 TRAILRIDER DR",
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"MailingAddressTelephoneNumber": "916-524-7020",
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"FirstLinePracticeLocationAddress": "2530 J ST STE 300",
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"EnumerationDate": "12/17/2025",
"LastUpdateDate": "12/17/2025",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SAMRAN",
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"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}