{
"Npi": {
"NPI": "1871861500",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PHILIP ENTE MD 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,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1111 E. OCEAN AVENUE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LOMPOC",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "93436",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "805-735-7623",
"MailingAddressFaxNumber": "805-735-7224",
"FirstLinePracticeLocationAddress": "1111 E OCEAN AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LOMPOC",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "93436-7076",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "805-735-7623",
"PracticeLocationAddressFaxNumber": "805-735-7224",
"EnumerationDate": "12/08/2011",
"LastUpdateDate": "12/08/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ENTE",
"AuthorizedOfficialFirstName": "PHILIP",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "805-735-7623",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": "A42029",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}