Active NPI
Patricia Kim, O.D.
- Optometrist
- Belmont, CA
National Provider Identifier
1295798536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 11676T
- Practice address
- 877 Ralston Ave
Belmont, CA 94002-2205 - Phone
- (650) 631-9882
- Fax
- (650) 631-9897
- NPI assigned
- Apr 8, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 11676T | CA | Primary |
Addresses
Primary practice location
877 Ralston Ave
Belmont, CA 94002-2205
Mailing address
877 Ralston Ave
Belmont, CA 94002-2205
Phone (650) 631-9882
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11676T | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358294400000",
"number": "1295798536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "877 RALSTON AVE",
"city": "BELMONT",
"state": "CA",
"postal_code": "940022205",
"telephone_number": "650-631-9882",
"fax_number": "650-631-9897"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "877 RALSTON AVE",
"city": "BELMONT",
"state": "CA",
"postal_code": "940022205",
"telephone_number": "650-631-9882",
"fax_number": "650-631-9897"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "PATRICIA",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-04-08",
"last_updated": "2013-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "11676T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Belmont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.