{
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "SOUTH PACIFIC PHYSICAL THERAPY INC",
"LastName": null,
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"FirstLineMailingAddress": "16161 VENTURA BLVD",
"SecondLineMailingAddress": "# C564",
"MailingAddressCityName": "ENCINO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91436-2522",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "818-907-0952",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4940 VAN NUYS BLVD",
"SecondLinePracticeLocationAddress": "#301",
"PracticeLocationAddressCityName": "SHERMAN OAKS",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91403-1700",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "818-907-0952",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/17/2016",
"LastUpdateDate": "12/01/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "AKRY",
"AuthorizedOfficialFirstName": "DOREEN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/PHYSICAL THERAPIST",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DPT",
"AuthorizedOfficialTelephoneNumber": "818-907-0952",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Physical Therapist",
"LicenseNumber": "PT36911",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"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."
}
}
}
}