{
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"EIN": null,
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"IsOrgSubpart": "N",
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"NamePrefix": null,
"NameSuffix": null,
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"FirstLineMailingAddress": "361 E WHITTIER BLVD",
"SecondLineMailingAddress": "F",
"MailingAddressCityName": "LA HABRA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90631-3842",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "562-691-9293",
"MailingAddressFaxNumber": "562-691-9220",
"FirstLinePracticeLocationAddress": "361 E WHITTIER BLVD",
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"PracticeLocationAddressCityName": "LA HABRA",
"PracticeLocationAddressStateName": "CA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "562-691-9293",
"PracticeLocationAddressFaxNumber": "562-691-9220",
"EnumerationDate": "03/04/2011",
"LastUpdateDate": "03/04/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ARIZA",
"AuthorizedOfficialFirstName": "HORACIO",
"AuthorizedOfficialMiddleName": "F",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "562-691-9293",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "208D00000X",
"TaxonomyName": "General Practice Physician",
"LicenseNumber": "A20388",
"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."
}
}
}
}