{
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"OrgName": "BARIATRIC AND MINIMALLY INVASIVE SURGERY OF HAWAII",
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"FirstLineMailingAddress": "PO BOX 4636",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HONOLULU",
"MailingAddressStateName": "HI",
"MailingAddressPostalCode": "96812-4636",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1301 PUNCHBOWL ST",
"SecondLinePracticeLocationAddress": "C/O WOUND CARE CLINIC",
"PracticeLocationAddressCityName": "HONOLULU",
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"PracticeLocationAddressTelephoneNumber": "310-194-4401",
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"EnumerationDate": "06/16/2009",
"LastUpdateDate": "06/16/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MANHAS-PRAKASH",
"AuthorizedOfficialFirstName": "SHARAN",
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"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "310-294-4401",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "208600000X",
"TaxonomyName": "Surgery Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"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."
}
}
}
}