{
"Npi": {
"NPI": "1891138301",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BURLINGAME SURGICAL CENTER 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": "27087 GRATIOT AVE",
"SecondLineMailingAddress": "2ND FL",
"MailingAddressCityName": "ROSEVILLE",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48066-2947",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "586-350-2655",
"MailingAddressFaxNumber": "586-498-9439",
"FirstLinePracticeLocationAddress": "1750 EL CAMINO REAL",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BURLINGAME",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "94010-3228",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "650-259-1480",
"PracticeLocationAddressFaxNumber": "650-697-7361",
"EnumerationDate": "04/15/2013",
"LastUpdateDate": "04/15/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CONNOLLY",
"AuthorizedOfficialFirstName": "JOHN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "650-259-1480",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QA1903X",
"TaxonomyName": "Ambulatory Surgical Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}