Individual provider Active NPI

Lorie Jihae Kook, O.D.

  • Optometrist
  • Paramount, CA
National Provider Identifier
1619947181
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT 11071T Issued in CA
Practice address
16444 Paramount Blvd
Ste 206
Paramount, CA 90723-5422
Phone
(323) 732-8111
Fax
(323) 638-2934
NPI assigned
Jan 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT 11071T CA Primary

Addresses

Primary practice location

16444 Paramount Blvd
Ste 206
Paramount, CA 90723-5422

Mailing address

16444 Paramount Blvd
Ste 206
Paramount, CA 90723-5422
Phone (323) 732-8111

Other identifiers 1

IdentifierTypeStateIssuer
SD110710MedicaidCA

Other names 1

  • Ji Hae Kook Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11071CAMDProfessional Counselor
OPT 11071TCAMDOptometrist

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1619947181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16444 PARAMOUNT BLVD",
            "address_2": "STE 206",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "907235422",
            "telephone_number": "323-732-8111",
            "fax_number": "323-638-2934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16444 PARAMOUNT BLVD",
            "address_2": "STE 206",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "907235422",
            "telephone_number": "323-732-8111",
            "fax_number": "323-638-2934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOK",
        "first_name": "LORIE",
        "middle_name": "JIHAE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 11071T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD110710",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JI",
            "last_name": "KOOK",
            "middle_name": "HAE",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Paramount, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.