Derek Soon Kwon, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

11681T Issued in CA

Practice address

731 N Euclid St
Anaheim, CA 92801-4116

Phone

(714) 533-8240

NPI assigned

Nov 2, 2006

Sex

Male

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

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.

• Dr. Derek Kwon Optometry, Inc

  • Optometrist
  • Anaheim, CA
  • NPI 1013174333
  Medicare reassignment NPD
• Crown Optometry

  • Optometrist
  • Anaheim, CA
  • NPI 1881187474
  NPD (past)

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1487732509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 N EUCLID ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928014116",
            "telephone_number": "714-533-8240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 N EUCLID ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928014116",
            "telephone_number": "714-533-8240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "DEREK",
        "middle_name": "SOON",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11681T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aeri Kwak
• Angela J Kwak, O.D.
• Jeneve Fern Kwan, PT
• Joseph Anthony Kwee, M.D.
• Christina Health Kwon
• Soonsi Kwon, O.D.
• Un-Kyung Lina Kwon, PHARM.D.
• Jeremiah V. Kwoon, MD
• Bee H. Kyaw
• Kyoung Tae Ha, D.D.S., Inc.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; 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.