Individual provider Active NPI

Kimberly Bohling, OD

  • Optometrist
  • Glendale, CA
National Provider Identifier
1356916365
Registry record updated Aug 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT34811-TLG Issued in CA
Practice address
232 S Brand Blvd
Glendale, CA 91204-1310
Phone
(818) 334-6630
NPI assigned
May 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT34811-TLG CA Primary

Addresses

Primary practice location

232 S Brand Blvd
Glendale, CA 91204-1310

Mailing address

232 S Brand Blvd
Glendale, CA 91204-1310
Phone (818) 334-6630

Other practice location 1

8129 W 3rd St
Los Angeles, CA 90048-4308
Phone (323) 419-0802

Other practice location 2

3916 W Sunset Blvd
Los Angeles, CA 90029-2242
Phone (323) 918-5291

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OPT34811-TLGCAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693008000000",
    "number": "1356916365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 S BRAND BLVD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912041310",
            "telephone_number": "818-334-6630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 S BRAND BLVD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912041310",
            "telephone_number": "818-334-6630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8129 W 3rd St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900484308",
            "country_code": "US",
            "telephone_number": "323-419-0802",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3916 W Sunset Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900292242",
            "country_code": "US",
            "telephone_number": "323-918-5291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOHLING",
        "first_name": "KIMBERLY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-21",
        "last_updated": "2023-08-26",
        "certification_date": "2023-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT34811-TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2023; 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.