{
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"FirstLineMailingAddress": "243 WALLIS ST UNIT 4",
"SecondLineMailingAddress": null,
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"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91106-5419",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "626-278-8727",
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"FirstLinePracticeLocationAddress": "959 E WALNUT ST STE 214",
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"PracticeLocationAddressTelephoneNumber": "626-808-4080",
"PracticeLocationAddressFaxNumber": "626-669-4080",
"EnumerationDate": "02/13/2024",
"LastUpdateDate": "02/13/2024",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RAHMAN",
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"AuthorizedOfficialCredential": "MD",
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"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}