{
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"FirstLineMailingAddress": "2471 PERALTA ST UNIT A",
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"MailingAddressCityName": "OAKLAND",
"MailingAddressStateName": "CA",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2471 PERALTA ST UNIT A",
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"PracticeLocationAddressCityName": "OAKLAND",
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"EnumerationDate": "04/14/2021",
"LastUpdateDate": "04/14/2021",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TA",
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"AuthorizedOfficialCredential": "PHARMD",
"AuthorizedOfficialTelephoneNumber": "949-331-7410",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Mail Order Pharmacy",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}