{
"Npi": {
"NPI": "1982367306",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "TRAN",
"FirstName": "KEVIN",
"MiddleName": null,
"NamePrefix": "MR.",
"NameSuffix": null,
"Credential": "PA-C",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "TRAN",
"OtherFirstName": "TANG",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "1355 MCCANDLESS DR APT 336",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MILPITAS",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95035-8160",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "415-613-9959",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1901 MONTEREY HWY STE 10",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAN JOSE",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "95112-6126",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "408-477-8080",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/21/2021",
"LastUpdateDate": "06/27/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "363A00000X",
"TaxonomyName": "Physician Assistant",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}