{
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"FirstLineMailingAddress": "1201 S BEACH BLVD STE 104B",
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"MailingAddressCityName": "LA HABRA",
"MailingAddressStateName": "CA",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "1201 S BEACH BLVD STE 104B",
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"EnumerationDate": "12/09/2008",
"LastUpdateDate": "12/09/2008",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KWON",
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"AuthorizedOfficialTelephoneNumber": "714-308-4206",
"Taxonomies": {
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"TaxonomyName": "Primary Care Clinic/Center",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}