Mimi Shen Kwong

Primary specialty

OptometristTaxonomy code 152W00000X

License

11824T Issued in CA

Practice address

3801 Miranda Ave
Palo Alto Vahcs/WBRC, Mail Stop #124
Palo Alto, CA 94304-1207

Phone

(650) 493-5000

Fax

(650) 496-2529

NPI assigned

Aug 8, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Mimi Ya-Ping Shen Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154331957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5289 YORKTON WAY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951302200",
            "telephone_number": "408-866-4260",
            "fax_number": "408-866-4260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 MIRANDA AVE",
            "address_2": "PALO ALTO VAHCS/WBRC, MAIL STOP #124",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041207",
            "telephone_number": "650-493-5000",
            "fax_number": "650-496-2529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWONG",
        "first_name": "MIMI",
        "middle_name": "SHEN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11824T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIMI",
            "last_name": "SHEN",
            "middle_name": "YA-PING",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Sharie Kwok
• Eric Son Kwon, DDS
• Rachel Kwon, DO
• Christopher Kwong, MD
• Joann Tze Ying Kwong, D.P.T
• Norra A Kwong, M.D.
• Erica Gia Ky
• Tyler C Ky, DO
• Hyun Jung Kye, PHARMD
• Hannah Marie Kyllo

• Optometrist in Palo Alto, CA
• Providers in Palo Alto, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.