{"npi":"1164588133","type":"NPI-2","status":"active","name":{"display":"Express Lens Lab, Inc.","other":[],"organization_name":"EXPRESS LENS LAB, INC.","authorised_official":"Brian Goldstone"},"specialty":{"primary_taxonomy":"332H00000X","primary_taxonomy_description":"Eyewear Supplier","slug":"eyewear-supplier","schema_org_specialty":null,"all":[{"code":"332H00000X","description":"Eyewear Supplier","primary":true,"state":"CA","license":"19209"}]},"addresses":[{"purpose":"LOCATION","street_1":"17150 NEWHOPE ST","city":"FOUNTAIN VALLEY","state":"CA","postal_code":"927084250","country_code":"US","street_2":"SUITE 305","phone":"7145451024","fax":"7145562026"},{"purpose":"MAILING","street_1":"17150 NEWHOPE ST","city":"FOUNTAIN VALLEY","state":"CA","postal_code":"927084250","country_code":"US","street_2":"SUITE 305","phone":"7145451024","fax":"7145562026"}],"license":{"state":"CA","number":"19209"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"772534","state":"AZ","issuer":null},{"type_code":"05","label":"Medicaid","value":"88272567","state":"NM","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2006-12-28","last_updated":"2020-08-22","_meta":{"source":"NPPES","snapshot_date":"2020-08-22","doc_url":"https://findmynpi.com/api"}}