{"npi":"1710905690","type":"NPI-2","status":"active","name":{"display":"Formula Medical Group A Professional Medical Corporation","other":[],"organization_name":"FORMULA MEDICAL GROUP A PROFESSIONAL MEDICAL CORPORATION","authorised_official":"James Krider"},"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":"CA","license":"G48897"}]},"addresses":[{"purpose":"LOCATION","street_1":"18182 US HIGHWAY 18","city":"APPLE VALLEY","state":"CA","postal_code":"923072200","country_code":"US","street_2":"SUITE 105","phone":"7602421234","fax":"7602425527"},{"purpose":"MAILING","street_1":"18182 US HIGHWAY 18","city":"APPLE VALLEY","state":"CA","postal_code":"923072200","country_code":"US","street_2":"SUITE 105","phone":"7602421234","fax":"7602425527"}],"license":{"state":"CA","number":"G48897"},"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20050714000153","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"CA","pac_id":"5193751808"}]},"enumeration_date":"2006-07-18","last_updated":"2020-05-14","_meta":{"source":"NPPES","snapshot_date":"2020-05-14","doc_url":"https://findmynpi.com/api"}}