{
"Npi": {
"NPI": "1043502792",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PACIFIC ASC LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1946 YOUNG ST",
"SecondLineMailingAddress": "SUITE 288",
"MailingAddressCityName": "HONOLULU",
"MailingAddressStateName": "HI",
"MailingAddressPostalCode": "96826-2169",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "808-949-2208",
"MailingAddressFaxNumber": "808-949-2209",
"FirstLinePracticeLocationAddress": "650 IWILEI RD",
"SecondLinePracticeLocationAddress": "SPACE #225",
"PracticeLocationAddressCityName": "HONOLULU",
"PracticeLocationAddressStateName": "HI",
"PracticeLocationAddressPostalCode": "96817-5086",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "808-949-2208",
"PracticeLocationAddressFaxNumber": "808-949-2209",
"EnumerationDate": "05/12/2011",
"LastUpdateDate": "05/12/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TONOKAWA",
"AuthorizedOfficialFirstName": "DOUGLAS",
"AuthorizedOfficialMiddleName": "M",
"AuthorizedOfficialTitle": "MEMBER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "808-949-2208",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QA1903X",
"TaxonomyName": "Ambulatory Surgical Clinic/Center",
"LicenseNumber": "PENDING",
"LicenseNumberStateCode": "HI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}