Individual provider Active NPI

Kevin Kwok, O.D.

  • Optometrist
  • Lakewood, CA
National Provider Identifier
1568813723
Registry record updated Feb 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
33431 Issued in CA
Practice address
3300 E South St
Suite 105
Lakewood, CA 90805-4549
Phone
(562) 531-2020
NPI assigned
Jun 28, 2016
Last updated
Feb 25, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 33431 CA Primary

Addresses

Primary practice location

3300 E South St
Suite 105
Lakewood, CA 90805-4549

Mailing address

3300 E South St
Suite 105
Lakewood, CA 90805-4549

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
I20161118000487 CA Practitioner - Optometry 8921387705 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33431CAMDLicensed Psychiatric Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakewood Eye Physicians and Surgeons Inc a Medical Group Optometrist Current Accepting new patients
Lakewood Eye Physicians and Surgeons Inc a Medical Group Optometrist CurrentSince Oct 8, 2016 Accepting new patients

Locations

3300 E South St
Ste 105
Lakewood, CA 90805
Phone (562) 232-1442

3801 Katella Ave
Ste 130
Los Alamitos, CA 90720
Phone (562) 430-3561

Interoperability endpoints

  • Direct secure messaging: kkwok@scepa.intellechartdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487980800000",
    "number": "1568813723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 E SOUTH ST",
            "address_2": "SUITE 105",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "908054549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 E SOUTH ST",
            "address_2": "SUITE 105",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "908054549",
            "telephone_number": "562-531-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWOK",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-28",
        "last_updated": "2017-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CA

Sources for this page

Verify at the official NPI Registry.