Kk0719 LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

KK0719 LLC

Doing business as

Anytime Glasses
California Optical Lab
Eyeveterans3 more in Other names

Practice address

1854 Business Center Dr
Duarte, CA 91010-2901

Phone

(626) 521-5600

NPI assigned

Feb 5, 2025

Organization subpart

No

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

Authorized official

Name

Kelly Kim

Title

Ceo

Phone

(213) 272-4436

Specialties & licenses 2

Addresses

Other names 6

• Anytime Glasses Doing business as
• California Optical Lab Doing business as
• Eyeveterans Doing business as
• John Ruvin Doing business as
• Sportifeye Optics Doing business as
• The Optic Lab Doing business as

Locations

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

{
    "created_epoch": "1738713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739836800000",
    "number": "1538973987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1854 BUSINESS CENTER DR",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "910102901",
            "telephone_number": "626-521-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1854 BUSINESS CENTER DR",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "910102901",
            "telephone_number": "626-521-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KK0719 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-05",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "213-272-4436"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anytime Glasses",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "California Optical Lab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eyeveterans",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "John Ruvin",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sportifeye Optics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Optic Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elisabeth McCauley King
• Felicia Kinnard, PA C
• Lucia Jimenez Kinsey, MSW, LCSW
• Yitian Timothy Kiong, M.D.
• Samer W. Kirmiz, MD
• Philip Joseph Klain, CRNA
• Justine Ko, M.D., M.P.H.
• Marianna Koczywas, MD
• Haig John Kojian, PH.D.
• Cecile K. Kokozian, NP

• Ophthalmology Physician in Duarte, CA
• Providers in Duarte, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; 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.