{
  "npi": "1003386103",
  "enumeration_type": "NPI-1",
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    "certification_date": "2026-08-28",
    "enumeration_date": "2018-11-30",
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      "address_1": "445 LEIGH AVE",
      "address_purpose": "MAILING",
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      "country_name": "United States",
      "postal_code": "950324000",
      "state": "CA",
      "telephone_number": "866-227-1211"
    },
    {
      "address_1": "10400 FRICOT CITY RD UNIT J",
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      "city": "SAN ANDREAS",
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      "country_name": "United States",
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    },
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      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
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  "enrichment": {
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    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": []
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}