{
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"FirstLineMailingAddress": "3-2600 KAUMUALII HWY",
"SecondLineMailingAddress": "SUITE #1508",
"MailingAddressCityName": "LIHUE",
"MailingAddressStateName": "HI",
"MailingAddressPostalCode": "96766-2040",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "808-245-8564",
"MailingAddressFaxNumber": "808-245-8565",
"FirstLinePracticeLocationAddress": "3-2600 KAUMUALII HWY",
"SecondLinePracticeLocationAddress": "SUITE 1508",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "808-245-8564",
"PracticeLocationAddressFaxNumber": "808-245-8565",
"EnumerationDate": "04/10/2007",
"LastUpdateDate": "12/10/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LOO",
"AuthorizedOfficialFirstName": "JERE",
"AuthorizedOfficialMiddleName": "H. E.",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "O.D.",
"AuthorizedOfficialTelephoneNumber": "808-245-8564",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Optometrist",
"LicenseNumber": "OD-254",
"LicenseNumberStateCode": "HI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}