{"npi":"1902128911","type":"NPI-2","status":"active","name":{"display":"Custom Compounding Centers LLC","other":[],"organization_name":"CUSTOM COMPOUNDING CENTERS LLC","authorised_official":"Paul Wheeler"},"specialty":{"primary_taxonomy":"3336C0004X","primary_taxonomy_description":"Compounding Pharmacy","slug":"compounding-pharmacy","schema_org_specialty":null,"all":[{"code":"333600000X","description":"Pharmacy","primary":false,"state":null,"license":null},{"code":"3336C0003X","description":"Community/Retail Pharmacy","primary":false,"state":null,"license":null},{"code":"3336C0004X","description":"Compounding Pharmacy","primary":true,"state":"CA","license":"PHY 50368"}]},"addresses":[{"purpose":"LOCATION","street_1":"10525 HUMBOLT ST","city":"LOS ALAMITOS","state":"CA","postal_code":"907205401","country_code":"US","phone":"7148942120","fax":"7148942150"},{"purpose":"MAILING","street_1":"10525 HUMBOLT ST","city":"LOS ALAMITOS","state":"CA","postal_code":"907205401","country_code":"US","phone":"7148942120","fax":"7148942150"}],"license":{"state":"CA","number":"PHY 50368"},"identifiers":[{"type_code":"01","label":"Other","value":"0590388","state":null,"issuer":"NCPDP PROVIDER IDENTIFICATION NUMBER"}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2010-02-17","last_updated":"2014-01-14","_meta":{"source":"NPPES","snapshot_date":"2014-01-14","doc_url":"https://findmynpi.com/api"}}