{
"Npi": {
"NPI": "1841587094",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BAIR",
"FirstName": "RYAN",
"MiddleName": "JAMES",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "M.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "5725 KEARNY VILLA RD STE I",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAN DIEGO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92123-1134",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "858-256-0351",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "769 MEDICAL CENTER COURT",
"SecondLinePracticeLocationAddress": "BARNHART CANCER CENTER",
"PracticeLocationAddressCityName": "CHULA VISTA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91911-9191",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "619-502-5851",
"PracticeLocationAddressFaxNumber": "619-502-5865",
"EnumerationDate": "07/07/2011",
"LastUpdateDate": "01/15/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "2085R0001X",
"TaxonomyName": "Radiation Oncology Physician",
"LicenseNumber": "125059011",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2085R0001X",
"TaxonomyName": "Radiation Oncology Physician",
"LicenseNumber": "C170527",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "2085R0001X",
"TaxonomyName": "Radiation Oncology Physician",
"LicenseNumber": "M-12990",
"LicenseNumberStateCode": "ID",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2085R0001X",
"TaxonomyName": "Radiation Oncology Physician",
"LicenseNumber": "10732A",
"LicenseNumberStateCode": "WY",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}