{
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"EIN": null,
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"FirstLineMailingAddress": "MSC 61436 PO BOX 1300",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HONOLULU",
"MailingAddressStateName": "HI",
"MailingAddressPostalCode": "96807-1300",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "808-949-9585",
"MailingAddressFaxNumber": "808-748-3311",
"FirstLinePracticeLocationAddress": "405 N KUAKINI ST STE 1105",
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"PracticeLocationAddressCityName": "HONOLULU",
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"PracticeLocationAddressTelephoneNumber": "808-532-2056",
"PracticeLocationAddressFaxNumber": "808-532-2058",
"EnumerationDate": "06/05/2007",
"LastUpdateDate": "09/18/2020",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "AWAYA",
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"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "808-532-2056",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207XS0117X",
"TaxonomyName": "Orthopaedic Surgery of the Spine Physician",
"LicenseNumber": "MD11251",
"LicenseNumberStateCode": "HI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}