Central Valley Eye Medical Group

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

CENTRAL VALLEY EYE MEDICAL GROUP

Practice address

36 W Yokuts Ave
Stockton, CA 95207-5713

Phone

(209) 952-3700

Fax

(209) 478-3302

NPI assigned

Apr 4, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stevens Y Kim, MDNPI 1437258183

Title

Treasurer

Phone

(209) 952-3700

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Central Valley Eye Medical Group3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Central Valley Eye Medical Group Inc.

  • Eyewear Supplier
  • Manteca, CA
  • NPI 1477675387
  NPD tax ID
• Central Valley Eye Medical Group Inc.

  • Ophthalmology Physician
  • Stockton, CA
  • NPI 1609975366
  NPD tax ID

Practitioners 1

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.

• Stevens Young-Jun Kim, MD

  • Ophthalmology Physician
  • Stockton, CA
  • NPI 1437258183
  Authorized official Same address or phone

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619099413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 W YOKUTS AVE",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075713",
            "telephone_number": "209-952-3700",
            "fax_number": "209-478-3302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 W YOKUTS AVE",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075713",
            "telephone_number": "209-952-3700",
            "fax_number": "209-478-3302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL VALLEY EYE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "STEVENS",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "209-952-3700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0076150",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Central Children's Health
• Central One Mobility
• Central Stockton Medical Clinic
• Central Valley Center for Community Advocacy, Inc.
• Central Valley Diabetes Self Management Program
• Central Valley Eye Medical Group Inc.
• Central Valley Gender Health & Wellness
• Central Valley Gender Health & Wellness
• Central Valley Low Income Housing Corp.
• Central Valley NE Medical Transportation, LLC

• Eyewear Supplier in Stockton, CA
• Providers in Stockton, CA by specialty
• Eyewear Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.