{
"Npi": {
"NPI": "1457543829",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DEL MAR HEALTH CLINIC, A PROFESSIONAL ACUPUNCTURE CORP.",
"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": "3223 DEL MAR AVE # 101",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ROSEMEAD",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91770-2327",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3223 DEL MAR AVE # 101",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ROSEMEAD",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91770-2327",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "626-280-9608",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/09/2007",
"LastUpdateDate": "08/14/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "XIE",
"AuthorizedOfficialFirstName": "ZHICHAO",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "ACUPUNCTURIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "626-280-9608",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "171100000X",
"TaxonomyName": "Acupuncturist",
"LicenseNumber": "AC 5985",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}