{
"Npi": {
"NPI": "1922293976",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PALM SURGICAL CENTER",
"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": "250 S LA CIENEGA BLVD",
"SecondLineMailingAddress": "# 204",
"MailingAddressCityName": "BEVERLY HILLS",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90211-3302",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "310-358-9300",
"MailingAddressFaxNumber": "310-358-9156",
"FirstLinePracticeLocationAddress": "250 S LA CIENEGA BLVD",
"SecondLinePracticeLocationAddress": "# 204",
"PracticeLocationAddressCityName": "BEVERLY HILLS",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90211-3302",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "310-358-9300",
"PracticeLocationAddressFaxNumber": "310-358-9156",
"EnumerationDate": "09/12/2007",
"LastUpdateDate": "09/12/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MALEK",
"AuthorizedOfficialFirstName": "MASOUD",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DR. MASOUD MALEK",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "310-358-9300",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QA1903X",
"TaxonomyName": "Ambulatory Surgical Clinic/Center",
"LicenseNumber": "A038198",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}