Individual provider Active NPI

Jina J Son, O.D.

  • Optometrist
  • Torrance, CA
National Provider Identifier
1417092305
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12528 T Issued in CA
Practice address
1860 W Carson St Ste 101
Torrance, CA 90501-2849
Phone
(310) 782-2220
Fax
(310) 782-6020
NPI assigned
Feb 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12528 T CA Primary

Addresses

Primary practice location

1860 W Carson St Ste 101
Torrance, CA 90501-2849

Mailing address

5058 Delacroix Rd
Rancho Palos Verdes, CA 90275-3900

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040916001074 CA Practitioner - Optometry 4183691264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1860 W Carson St
Suite 101
Torrance, CA 90501-2849
Phone (310) 782-2220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12528 TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Jina Son Optometry, Inc Optometrist CurrentSince Jan 1, 2008 Accepting new patients
Nu-Crown, LLC Optometrist Past Accepting new patients

Locations

1757 W Carson St
Ste O
Torrance, CA 90501
Phone (310) 782-2220

1860 W Carson St
Ste 101
Torrance, CA 90501
Phone (310) 782-2220

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1417092305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5058 DELACROIX RD",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902753900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 W CARSON ST STE 101",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905012849",
            "telephone_number": "310-782-2220",
            "fax_number": "310-782-6020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SON",
        "first_name": "JINA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12528 T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.