{
"Npi": {
"NPI": "1942734967",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "RESTORATION HEALTH 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": "2021 22ND ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BAKERSFIELD",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "93301-3802",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "661-447-4200",
"MailingAddressFaxNumber": "661-447-4100",
"FirstLinePracticeLocationAddress": "7011 N HOWARD ST",
"SecondLinePracticeLocationAddress": "SUITE 101",
"PracticeLocationAddressCityName": "FRESNO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "93720-2955",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "559-261-2700",
"PracticeLocationAddressFaxNumber": "559-261-0333",
"EnumerationDate": "04/17/2017",
"LastUpdateDate": "04/17/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SHAKERI",
"AuthorizedOfficialFirstName": "REZA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "VICE PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "559-977-8910",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "DC0259290",
"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."
}
}
}
}