Joanne Ji Yun Kim, O.D

Primary specialty

OptometristTaxonomy code 152W00000X

License

13418T Issued in CA

Practice address

14147 Pipeline Ave
Chino, CA 91710-5618

Phone

(909) 628-0300

NPI assigned

Sep 25, 2007

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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Rancho Vision Center Optometry Inc

  • Optometrist
  • Rancho Cucamonga, CA
  • NPI 1588205298
  Medicare reassignment NPD Authorized official
• Dr. Kim Optometry Inc

  • Optometrist
  • La Verne, CA
  • NPI 1801726369
  NPD Authorized official
• Joseph P Trezza & James M Tatum, Inc.

  • Optometrist
  • Rancho Cucamonga, CA
  • NPI 1598713794
  NPD
• Soo Youn Kim OD Inc

  • Eyewear Supplier
  • Chino, CA
  • NPI 1053594846
  NPD (past)

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1336336239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14147 PIPELINE AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917105618",
            "telephone_number": "909-628-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14147 PIPELINE AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917105618",
            "telephone_number": "909-628-0300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10165 Foothill Blvd Ste 6",
            "address_purpose": "LOCATION",
            "city": "Rancho Cucamonga",
            "state": "CA",
            "postal_code": "917300341",
            "country_code": "US",
            "telephone_number": "909-987-0728",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JOANNE",
        "middle_name": "JI YUN",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-25",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13418T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Deoksu Kim, PHARM.D.
• Eun a Kim, MSAOM
• Jay Kim, PHARMD
• Ji Hong Kim, PSY.D.
• Jin Ho Kim, PHARMACIST
• Jua Grace Kim, MFTI
• Katie Kim
• Mijong Julie Kim
• Min Young Kim, D.D.S.
• Paul Young Kim, DPT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.