Jimmy K. So, OD, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

10554T Issued in CA

Legal business name

JIMMY K. SO, OD, INC.

Practice address

1261 W Foothill Blvd Ste B
Upland, CA 91786-8019

Phone

(909) 982-9366

Fax

(909) 982-2477

NPI assigned

Feb 24, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Jimmy K. So, O.D.NPI 1548233059

Title

President

Phone

(909) 982-9366

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

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

• Jimmy K. So, OD

  • Optometrist
  • Upland, CA
  • NPI 1548233059
  Medicare reassignment Authorized official
• Tina Thuytram DO, O.D.

  • Optometrist
  • Anaheim, CA
  • NPI 1558331975
  NPD (past)
• Hollie H Huynh, OD

  • Optometrist
  • Garden Grove, CA
  • NPI 1174636872
  NPD (past)

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

{
    "created_epoch": "1393200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393200000000",
    "number": "1154746345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1261 W FOOTHILL BLVD STE B",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917868019",
            "telephone_number": "909-982-9366",
            "fax_number": "909-982-2477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1261 W FOOTHILL BLVD STE B",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917868019",
            "telephone_number": "909-982-9366",
            "fax_number": "909-982-2477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIMMY K. SO, OD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-24",
        "last_updated": "2014-02-24",
        "status": "A",
        "authorized_official_last_name": "SO",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-982-9366",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10554T",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "10554T",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jimena Jimenez
• Jose Alejandro Jimenez
• Louise Jimenez
• Rachel May Jimenez, MSN, FNP
• Jimmy K So OD Inc
• Jin Wang MD Inc
• John D Sauter DDS MDS Ortho Dental GP Inc
• John J Kim MD Inc
• Connie Joanne Johnshoy-Currie, PSY.D.
• A'Ryann Johnson

• Optometrist in Upland, CA
• Providers in Upland, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.