{
"Npi": {
"NPI": "1972982114",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CMMP CLINICA DE OJOS",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2007 WILSHIRE BLVD",
"SecondLineMailingAddress": "SUITE 522",
"MailingAddressCityName": "LOS ANGELES",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90057-3506",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "213-805-6005",
"MailingAddressFaxNumber": "213-805-6001",
"FirstLinePracticeLocationAddress": "2007 WILSHIRE BLVD",
"SecondLinePracticeLocationAddress": "SUITE 522",
"PracticeLocationAddressCityName": "LOS ANGELES",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90057-3506",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "213-805-6005",
"PracticeLocationAddressFaxNumber": "213-805-6001",
"EnumerationDate": "05/20/2015",
"LastUpdateDate": "05/20/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MONTOYA",
"AuthorizedOfficialFirstName": "CARLOS",
"AuthorizedOfficialMiddleName": "FRANCISCO",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": "SR.",
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "714-393-8809",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QS0132X",
"TaxonomyName": "Ophthalmologic Surgery Clinic/Center",
"LicenseNumber": "A40547",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}