{
"Npi": {
"NPI": "1558734921",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "EUN KIM 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": "13240 ABANA PLACE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CERRITOS",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90703",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "714-494-9355",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "411 ATLAS STREET",
"SecondLinePracticeLocationAddress": "SUITE A",
"PracticeLocationAddressCityName": "BREA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92821",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "714-494-9355",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/07/2015",
"LastUpdateDate": "09/20/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KIM",
"AuthorizedOfficialFirstName": "EUN",
"AuthorizedOfficialMiddleName": "CHA",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.C., L.AC",
"AuthorizedOfficialTelephoneNumber": "714-494-9355",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "171100000X",
"TaxonomyName": "Acupuncturist",
"LicenseNumber": "16209",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": [
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
]
}
}
}