{
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"FirstLineMailingAddress": "1288 KAPIOLANI BLVD APT 2407",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HONOLULU",
"MailingAddressStateName": "HI",
"MailingAddressPostalCode": "96814-2871",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "626-422-2863",
"MailingAddressFaxNumber": "808-800-2698",
"FirstLinePracticeLocationAddress": "955 WAIMANU ST",
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"PracticeLocationAddressCityName": "HONOLULU",
"PracticeLocationAddressStateName": "HI",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "808-888-8989",
"PracticeLocationAddressFaxNumber": "808-800-2698",
"EnumerationDate": "07/02/2018",
"LastUpdateDate": "01/29/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LIN",
"AuthorizedOfficialFirstName": "JIMMY",
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"AuthorizedOfficialCredential": "PT, DPT",
"AuthorizedOfficialTelephoneNumber": "626-422-2863",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "2251X0800X",
"TaxonomyName": "Orthopedic Physical Therapist",
"LicenseNumber": "3758",
"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."
}
}
}
}