Kelly Mui, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

12896 Issued in CA

Practice address

11777 San Vicente Blvd
Suite 130
Los Angeles, CA 90049-5011

Phone

(310) 820-2020

NPI assigned

Oct 17, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Paul J Super OD a Professional Corporation

  • Optometrist
  • Los Angeles, CA
  • NPI 1457681371
  NPD (past)

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1063401719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 OCEAN PARK BLVD",
            "address_2": "SUITE 107 PMB 88",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904053301",
            "telephone_number": "510-220-1779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11777 SAN VICENTE BLVD",
            "address_2": "SUITE 130",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900495011",
            "telephone_number": "310-820-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUI",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maryam Bint Muhammad
• Bethany K. Muhl, L.AC.
• Lauren Siegler Muhlheim, PSY.D.
• Ilana Muhlstein, R.D.
• Peter Hyunwoo Muhn, D.P.T.
• Agnes Wambui Muigai
• Holly Ann Muir, M.D.
• Susie Jane Muir, MD
• John David Mujule
• Hana Gabriella Mukadam

• Optometrist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.