{
"Npi": {
"NPI": "1265620306",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "PARK",
"FirstName": "SAM",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "BILLER",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": null,
"SecondLineMailingAddress": null,
"MailingAddressCityName": null,
"MailingAddressStateName": null,
"MailingAddressPostalCode": null,
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": null,
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": null,
"PracticeLocationAddressStateName": null,
"PracticeLocationAddressPostalCode": null,
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": null,
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/12/2007",
"LastUpdateDate": "08/18/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MARINI",
"AuthorizedOfficialFirstName": "ROBERTO",
"AuthorizedOfficialMiddleName": "A",
"AuthorizedOfficialTitle": "BILLER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "562-964-9821",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": null,
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}