Blue Sky Optometry

Primary specialty

OptometristTaxonomy code 152W00000X

License

13140T Issued in CA

Legal business name

BLUE SKY OPTOMETRY

Practice address

720 E. Valley Blvd.
San Gabriel, CA 91776-3547

Phone

(626) 288-8097

Fax

(626) 288-8360

NPI assigned

May 11, 2007

Organization subpart

No

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

Authorized official

Name

Jane Kim, O.D.NPI 1891874574

Title

Owner

Phone

(626) 288-8097

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jane Kim, O.D.

  • Optometrist
  • Pasadena, CA
  • NPI 1891874574
  NPD (past) Authorized official
• James Chung, O.D.

  • Optometrist
  • San Gabriel, CA
  • NPI 1194818518
  NPD (past)

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619182839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 E. VALLEY BLVD.",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763547",
            "telephone_number": "626-288-8097",
            "fax_number": "626-288-8360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 E. VALLEY BLVD.",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763547",
            "telephone_number": "626-288-8097",
            "fax_number": "626-288-8360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE SKY OPTOMETRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-288-8097",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13140T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0131400",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in San Gabriel, CA
• Providers in San Gabriel, CA by specialty
• Optometrist 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.