{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HARRY DASSAH INC",
"LastName": null,
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"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
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"FirstLineMailingAddress": "405 BOYD ST",
"SecondLineMailingAddress": "830 UNION AVE. FAIRFIELD",
"MailingAddressCityName": "VACAVILLE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95688-4521",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "707-449-0483",
"MailingAddressFaxNumber": "707-448-0443",
"FirstLinePracticeLocationAddress": "405 BOYD ST",
"SecondLinePracticeLocationAddress": "830 UNION AVE. FAIRFIELD CA 94533- SECOND LOCATION",
"PracticeLocationAddressCityName": "VACAVILLE",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "95688-4521",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "707-449-0483",
"PracticeLocationAddressFaxNumber": "707-448-0443",
"EnumerationDate": "10/18/2006",
"LastUpdateDate": "08/13/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DASSAH",
"AuthorizedOfficialFirstName": "HARRY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "707-449-0483",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207RC0000X",
"TaxonomyName": "Cardiovascular Disease Physician",
"LicenseNumber": "A385030",
"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."
}
}
}
}