Organization Active NPI

Joseph K. Kikumoto, O.D.

  • Optometrist
  • San Juan Capistrano, CA
National Provider Identifier
1508030727
Registry record updated Apr 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8759TPL Issued in CA
Legal business name
JOSEPH K. KIKUMOTO, O.D.
Practice address
31401 Rancho Viejo Rd
Suite 103
San Juan Capistrano, CA 92675-1851
Phone
(949) 443-3794
NPI assigned
Apr 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2008

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

Authorized official

Name
Dr. Joseph Keith Kikumoto, O.D.
Title
Owner
Phone
(949) 443-3794

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 8759TPL CA Primary

Addresses

Primary practice location

31401 Rancho Viejo Rd
Suite 103
San Juan Capistrano, CA 92675-1851

Mailing address

31401 Rancho Viejo Rd
Suite 103
San Juan Capistrano, CA 92675-1851
Phone (949) 443-3794

National Provider Directory

National Provider Directory

Locations

31401 Rancho Viejo Rd
Ste 103
San Juan Capo, CA 92675
Phone (949) 443-3794

NPI Registry JSON

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

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208476800000",
    "number": "1508030727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31401 RANCHO VIEJO RD",
            "address_2": "SUITE 103",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751851",
            "telephone_number": "949-443-3794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31401 RANCHO VIEJO RD",
            "address_2": "SUITE 103",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751851",
            "telephone_number": "949-443-3794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH K. KIKUMOTO, O.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-18",
        "last_updated": "2008-04-18",
        "status": "A",
        "authorized_official_last_name": "KIKUMOTO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-443-3794",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8759TPL",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan Capistrano, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; 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.