Crystal Kim

Primary specialty

OptometristTaxonomy code 152W00000X

License

33716 Issued in CA

Practice address

21600 Hawthorne Blvd
Torrance, CA 90503-5710

Phone

(310) 214-0409

NPI assigned

Jun 27, 2017

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

Specialty

Optometry

Education

Southern College of Optometry, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kenneth J Miller MD a Medical CorpGroup PAC ID 9234166695, 4 clinicians

Practice addresses (Care Compare)

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.

• Peninsula Eyecare Medical Associates

  • Ophthalmology Physician
  • San Pedro, CA
  • NPI 1033131933
  Medicare reassignment Care Compare group NPD
• Luxottica of America Inc.

  • Eyewear Supplier
  • Torrance, CA
  • NPI 1275084238
  NPD (past)
• Luxottica of America Inc

  • Eyewear Supplier
  • Kansas City, MO
  • NPI 1497412522
  NPD (past)

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

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1356861645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21600 HAWTHORNE BLVD",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905035710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21600 HAWTHORNE BLVD",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905035710",
            "telephone_number": "310-214-0409"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9 Rockinghorse Rd",
            "address_purpose": "LOCATION",
            "city": "Rancho Palos Verdes",
            "state": "CA",
            "postal_code": "90275",
            "country_code": "US",
            "telephone_number": "310-951-9337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "CRYSTAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-27",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Minyee Kim, D.C.
• Christopher Sung-Bo Kim, M.D.
• Chul Kim, D.P.M
• Chul Soo Kim, LAC
• Cindy Kim, MD
• Dabin Kim
• Daniel J Kim
• David O Kim, M.D.
• David Sehwan Kim, MD
• David Sung Kim

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.