{
"Npi": {
"NPI": "1831562487",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CORE INTEGRATED HEALTH",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "10801 FOOTHILL BLVD",
"SecondLineMailingAddress": "SUITE 104",
"MailingAddressCityName": "RANCHO CUCAMONGA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91730-7694",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "909-989-4435",
"MailingAddressFaxNumber": "909-989-4461",
"FirstLinePracticeLocationAddress": "10801 FOOTHILL BLVD",
"SecondLinePracticeLocationAddress": "SUITE 104",
"PracticeLocationAddressCityName": "RANCHO CUCAMONGA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91730-7694",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "909-989-4435",
"PracticeLocationAddressFaxNumber": "909-989-4461",
"EnumerationDate": "11/04/2015",
"LastUpdateDate": "11/04/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LANYON",
"AuthorizedOfficialFirstName": "CORAZON",
"AuthorizedOfficialMiddleName": "C",
"AuthorizedOfficialTitle": "OWNER, CLINIC DIRECTOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "909-989-4435",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "171100000X",
"TaxonomyName": "Acupuncturist",
"LicenseNumber": "AC 11452",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "23557",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": [
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
]
}
}
}