{
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"PracticeLocationAddressFaxNumber": "909-888-5611",
"EnumerationDate": "08/03/2012",
"LastUpdateDate": "08/03/2012",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PARK-LEE",
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"AuthorizedOfficialMiddleName": "MIEUN",
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"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "909-888-5499",
"Taxonomies": {
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{
"TaxonomyCode": "122300000X",
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},
{
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}
]
},
"HealthcareProviderTaxonomyGroups": {
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{
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},
{
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
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}
]
}
}
}