NPIMap

Organization Active NPI

Julie Kang-Kim Optometric Corporation

  • Optometrist
  • Van Nuys, CA
National Provider Identifier
1063697456
Registry record updated Sep 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9480T Issued in CA
Legal business name
JULIE KANG-KIM OPTOMETRIC CORPORATION
Practice address
7100 Van Nuys Blvd
208
Van Nuys, CA 91405-3063
Phone
(818) 786-0796
Fax
(818) 786-1706
NPI assigned
Jan 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2011

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

Authorized official

Name
Dr. Julie M Kang-Kim, O.D.
Title
President
Phone
(818) 786-0796

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 9480T CA Primary

Addresses

Primary practice location

7100 Van Nuys Blvd
208
Van Nuys, CA 91405-3063

Mailing address

7100 Van Nuys Blvd
208
Van Nuys, CA 91405-3063
Phone (818) 786-0796

Other identifiers 1

IdentifierTypeStateIssuer
GSD000040MedicaidCA

Other names 1

  • Valley Optometric Associates Doing business as

National Provider Directory

National Provider Directory

Locations

7100 Van Nuys Blvd
Ste 208
Van Nuys, CA 91405
Phone (818) 786-0796

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315353600000",
    "number": "1063697456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 VAN NUYS BLVD",
            "address_2": "208",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053063",
            "telephone_number": "818-786-0796",
            "fax_number": "818-786-1706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 VAN NUYS BLVD",
            "address_2": "208",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053063",
            "telephone_number": "818-786-0796",
            "fax_number": "818-786-1706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JULIE KANG-KIM OPTOMETRIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-03",
        "last_updated": "2011-09-07",
        "status": "A",
        "authorized_official_last_name": "KANG-KIM",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-786-0796",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9480T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSD000040",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Optometric Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2011; 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.