{
"Npi": {
"NPI": "1932410834",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PANBEHI ANESTHESIA SERVICES, 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": "PO BOX 4331",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "INGLEWOOD",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90309-4331",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "424-206-1919",
"MailingAddressFaxNumber": "310-303-7944",
"FirstLinePracticeLocationAddress": "1300 W 7TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAN PEDRO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90732-3505",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "424-206-1919",
"PracticeLocationAddressFaxNumber": "310-303-7944",
"EnumerationDate": "06/24/2010",
"LastUpdateDate": "06/24/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "APODACA",
"AuthorizedOfficialFirstName": "MARIA",
"AuthorizedOfficialMiddleName": "A.",
"AuthorizedOfficialTitle": "ACCOUNT REPRESENTATIVE",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "OFFICE MANAGER",
"AuthorizedOfficialTelephoneNumber": "424-206-1919",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207L00000X",
"TaxonomyName": "Anesthesiology Physician",
"LicenseNumber": "A72512",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}