{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SOHAM CHIROPRACTIC CORP",
"LastName": null,
"FirstName": null,
"MiddleName": null,
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"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "12335 WORLD TRADE DR STE 1A",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAN DIEGO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92128-3783",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "858-432-3072",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "12335 WORLD TRADE DR STE 1A",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAN DIEGO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92128-3783",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "858-432-3072",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/19/2022",
"LastUpdateDate": "01/19/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SOHAM",
"AuthorizedOfficialFirstName": "VIVEK",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "407-725-4515",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}