{
"Npi": {
"NPI": "1871635243",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "UYANNE",
"FirstName": "JOHN",
"MiddleName": "AZUBIKE",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 985 ARTESIA CA 90702",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ARTESIA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90702",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "562-706-2612",
"MailingAddressFaxNumber": "562-802-7979",
"FirstLinePracticeLocationAddress": "8110 AIRPORT BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LOS ANGELES",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90045",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "562-706-2612",
"PracticeLocationAddressFaxNumber": "562-802-7978",
"EnumerationDate": "02/13/2007",
"LastUpdateDate": "07/08/2007",
"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": "207RG0300X",
"TaxonomyName": "Geriatric Medicine (Internal Medicine) Physician",
"LicenseNumber": "A70516",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "207RG0300X",
"TaxonomyName": "Geriatric Medicine (Internal Medicine) Physician",
"LicenseNumber": "9217",
"LicenseNumberStateCode": "NV",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}