{
"Npi": {
"NPI": "1871679837",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "R. S. RAJAH, M.D., INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "13847 E 14TH ST",
"SecondLineMailingAddress": "SUITE 112",
"MailingAddressCityName": "SAN LEANDRO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "94578-2632",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "510-895-9721",
"MailingAddressFaxNumber": "510-895-5283",
"FirstLinePracticeLocationAddress": "13847 E 14TH ST",
"SecondLinePracticeLocationAddress": "SUITE 112",
"PracticeLocationAddressCityName": "SAN LEANDRO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "94578-2632",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "510-895-9721",
"PracticeLocationAddressFaxNumber": "510-895-5283",
"EnumerationDate": "10/31/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RAJAH",
"AuthorizedOfficialFirstName": "RATNASOTHY",
"AuthorizedOfficialMiddleName": "S",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "510-895-9721",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "174400000X",
"TaxonomyName": "Specialist",
"LicenseNumber": "A29661",
"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."
}
}
}
}