{
"Npi": {
"NPI": "1265576219",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JUNG SUN LEE",
"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": "3663 W 6TH ST",
"SecondLineMailingAddress": "SUITE 102",
"MailingAddressCityName": "LOS ANGELES",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90020-3049",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "213-383-8877",
"MailingAddressFaxNumber": "213-368-1590",
"FirstLinePracticeLocationAddress": "3663 W 6TH ST",
"SecondLinePracticeLocationAddress": "SUITE 102",
"PracticeLocationAddressCityName": "LOS ANGELES",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90020-3049",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "213-383-8877",
"PracticeLocationAddressFaxNumber": "213-368-1590",
"EnumerationDate": "02/16/2007",
"LastUpdateDate": "08/01/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LEE",
"AuthorizedOfficialFirstName": "JUNG SUN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER, PHARMACIST",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "213-383-8877",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "PHY 37825",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}