Soo Youn Kim OD Inc

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

OPT10349TPA Issued in CA

Legal business name

SOO YOUN KIM OD INC

Practice address

14147 Pipeline Ave
Chino, CA 91710-5618

Phone

(909) 628-0300

NPI assigned

Dec 14, 2007

Organization subpart

Yes

Parent organization

ZZZ25706ZAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Soo Youn Kim, O.D

Title

Owner

Phone

(909) 628-0300

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Fashion Eyes Optometry Doing business as

Part of

Soo Youn Kim OD Inc

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joanne Ji Yun Kim, O.D

  • Optometrist
  • Chino, CA
  • NPI 1336336239
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1197590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232668800000",
    "number": "1053594846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14147 PIPELINE AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917105618",
            "telephone_number": "909-628-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14147 PIPELINE AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917105618",
            "telephone_number": "909-628-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOO YOUN KIM OD INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ZZZ25706Z",
        "enumeration_date": "2007-12-14",
        "last_updated": "2009-01-23",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SOO",
        "authorized_official_middle_name": "YOUN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-628-0300",
        "authorized_official_credential": "O.D"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "CA",
            "license": "OPT10349TPA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0125235",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fashion Eyes Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Claudia Elizabeth Somoano, LMFT
• David Song
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• Christa Soryal, DDS
• Priscilla Esther Sosa
• Sotara Manalo Rico Professional Medical Corporation
• South Coast Children'S Society, Inc
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• Eyewear Supplier in Chino, CA
• Providers in Chino, CA by specialty
• Eyewear Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.