{
"Npi": {
"NPI": "1770766776",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "PARK",
"FirstName": "KWANG",
"MiddleName": "HEE",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "L.AC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "PARK",
"OtherFirstName": "KWANG",
"OtherMiddleName": "HEE",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "PH.D.",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "522 E ORANGE GROVE BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PASADENA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91104-4351",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "626-792-6223",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "522 E ORANGE GROVE BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PASADENA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91104-4351",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "626-792-6223",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/12/2007",
"LastUpdateDate": "12/12/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "171100000X",
"TaxonomyName": "Acupuncturist",
"LicenseNumber": "AC11357",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}