{"npi":"1255904207","type":"NPI-2","status":"active","name":{"display":"Modmd A Professional Corporation","other":[],"organization_name":"MODMD A PROFESSIONAL CORPORATION","authorised_official":"Sharon Dabby"},"specialty":{"primary_taxonomy":"291U00000X","primary_taxonomy_description":"Clinical Medical Laboratory","slug":"clinical-medical-laboratory","schema_org_specialty":"Pathology","all":[{"code":"207P00000X","description":"Emergency Medicine","primary":false,"state":null,"license":null},{"code":"291U00000X","description":"Clinical Medical Laboratory","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"208 LINCOLN BLVD","city":"VENICE","state":"CA","postal_code":"90291","country_code":"US","phone":"8336636352","fax":"4244653398"},{"purpose":"MAILING","street_1":"208 LINCOLN BLVD","city":"VENICE","state":"CA","postal_code":"90291","country_code":"US","phone":"8336636352","fax":"4244653398"}],"license":null,"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20211006001934","type_code":"12-69","type_desc":"PART B SUPPLIER - INDEPENDENT CLINICAL LABORATORY","state":"CA","pac_id":"3375941339"}]},"enumeration_date":"2021-07-19","last_updated":"2023-02-04","_meta":{"source":"NPPES","snapshot_date":"2023-02-04","doc_url":"https://findmynpi.com/api"}}