{
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"FirstLineMailingAddress": "5435 BALBOA BLVD",
"SecondLineMailingAddress": "STE 105",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "818-345-0545",
"MailingAddressFaxNumber": "818-386-2451",
"FirstLinePracticeLocationAddress": "5435 BALBOA BLVD",
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"EnumerationDate": "01/04/2006",
"LastUpdateDate": "03/04/2008",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TSIKANOVSKY",
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"AuthorizedOfficialCredential": "RN",
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"Taxonomies": {
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}
},
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}
}