Organization Active NPI

Gold Optometry Inc.

Doing business as Gold Optometry

  • Optometrist
  • Los Angeles, CA
National Provider Identifier
1487703963
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12591T Issued in CA
Legal business name
GOLD OPTOMETRY INC.
Doing business as
Gold Optometry
Practice address
928 S Western Ave Ste 229
Los Angeles, CA 90006-1084
Phone
(213) 384-1001
Fax
(213) 384-4527
NPI assigned
Jan 10, 2007
Last updated
Sep 23, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Authorized official

Name
Michelle H Kim, ODNPI 1588713119
Title
President
Phone
(213) 384-1001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12591T CA Primary

Addresses

Primary practice location

928 S Western Ave Ste 229
Los Angeles, CA 90006-1084

Mailing address

928 S Western Ave Ste 229
Los Angeles, CA 90006-1084
Phone (213) 384-1001

Other identifiers 1

IdentifierTypeStateIssuer
GSD005480MedicaidCA

Other names 1

  • Gold Optometry Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150605002881 CA Part B Supplier - Clinic/Group Practice 6103147806 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
Practice locations: Garden Grove, CA; Los Angeles, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Gold Optometry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

833 S Western Ave
Ste 2
Los Angeles, CA 90005
Phone (213) 334-1001

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790121600000",
    "number": "1487703963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 S WESTERN AVE STE 229",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900061084",
            "telephone_number": "213-384-1001",
            "fax_number": "213-384-4527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 S WESTERN AVE STE 229",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900061084",
            "telephone_number": "213-384-1001",
            "fax_number": "213-384-4527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLD OPTOMETRY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-384-1001",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12591T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSD005480",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gold Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.