{
"Npi": {
"NPI": "1255761367",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MYUNG SIM DANG CHIROPRACTIC INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "11867 ARTESIA BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ARTESIA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90701-4002",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "562-809-2535",
"MailingAddressFaxNumber": "562-809-7714",
"FirstLinePracticeLocationAddress": "11867 ARTESIA BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ARTESIA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90701-4002",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "562-809-2535",
"PracticeLocationAddressFaxNumber": "562-809-7714",
"EnumerationDate": "11/26/2013",
"LastUpdateDate": "12/23/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KANG",
"AuthorizedOfficialFirstName": "BENJAMIN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.C",
"AuthorizedOfficialTelephoneNumber": "562-809-2535",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "305R00000X",
"TaxonomyName": "Preferred Provider Organization",
"LicenseNumber": "DC 24437",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "305R00000X",
"TaxonomyName": "Preferred Provider Organization",
"LicenseNumber": "AC 3608",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}