{"npi":"1497776322","type":"NPI-2","status":"active","name":{"display":"Centro Medico Inc.","other":[],"organization_name":"CENTRO MEDICO INC.","authorised_official":"Nabil Soliman"},"specialty":{"primary_taxonomy":"207Q00000X","primary_taxonomy_description":"Family Medicine","slug":"family-medicine","schema_org_specialty":"PrimaryCare","all":[{"code":"207Q00000X","description":"Family Medicine","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"11946 HAWTHORNE BLVD.","city":"HAWTHORNE","state":"CA","postal_code":"902503016","country_code":"US","phone":"3106751136","fax":"3109701447"},{"purpose":"MAILING","street_1":"11946 HAWTHORNE BLVD.","city":"HAWTHORNE","state":"CA","postal_code":"902503016","country_code":"US","phone":"3106751136","fax":"3109701447"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"GR0057390","state":"CA","issuer":null},{"type_code":"01","label":"Other","value":"ZZZ39006Z","state":"CA","issuer":"BLUE SHIELD PROVIDER #"}],"pecos":{"enrolled_at":"2026-07-01T15:01:53.235063+00:00","enrollments":[{"enrlmt_id":"O20101108000510","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"CA","pac_id":"2163617846"}]},"enumeration_date":"2006-07-23","last_updated":"2023-05-23","_meta":{"source":"NPPES","snapshot_date":"2023-05-23","doc_url":"https://findmynpi.com/api"}}