{
"Npi": {
"NPI": "1902056518",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "QUANTUM HEALTHCARE INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 12112",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAN BERNARDINO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92423-2112",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "760-321-2800",
"MailingAddressFaxNumber": "760-321-7277",
"FirstLinePracticeLocationAddress": "35400 BOB HOPE DR",
"SecondLinePracticeLocationAddress": "SUITE 205",
"PracticeLocationAddressCityName": "RANCHO MIRAGE",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92270-1772",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "760-321-2800",
"PracticeLocationAddressFaxNumber": "760-321-7277",
"EnumerationDate": "09/19/2008",
"LastUpdateDate": "01/30/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LUONG",
"AuthorizedOfficialFirstName": "KHANH",
"AuthorizedOfficialMiddleName": "CONG",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "760-321-2800",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2000X",
"TaxonomyName": "Physical Therapy Clinic/Center",
"LicenseNumber": "PT 29464",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}