Individual provider Active NPI

Joshua Hangul Yim, OD

  • Optometrist
  • Ontario, CA
National Provider Identifier
1669241063
Registry record updated Jan 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
36148-TLG Issued in CA
Practice address
3155D Sedona CT
Ontario, CA 91764-6555
Phone
(909) 605-1975
Fax
(909) 974-0356
NPI assigned
Dec 27, 2023
Last updated
Jan 16, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 36148-TLG CA Primary
Optometrist 152W00000X 1184 NV

Addresses

Primary practice location

3155D Sedona CT
Ontario, CA 91764-6555

Mailing address

3155D Sedona CT
Ontario, CA 91764-6555
Phone (909) 605-1975

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240513000954 NV Practitioner - Optometry 8729429402 Reassigns benefits to 1 organization
I20260202002252 CA Practitioner - Optometry 8729429402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

75 Enterprise
Suite 200
Aliso Viejo, CA 92656-2626

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36148-TLGCAMDOptometrist
36148CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Las Vegas Family Eye Care, Todd C. Angell, O.D. LTD Optometrist CurrentSince Mar 31, 2024 Accepting new patients
Thomas S Tooma M D a Professional Corporation Optometrist CurrentSince Dec 21, 2025 Accepting new patients
Thomas S Tooma M D a Professional Corporation Optometrist CurrentSince Dec 21, 2025 Accepting new patients

Locations

3155 Sedona Ct
Ste 100
Ontario, CA 91764
Phone (909) 605-1975

3155 Sedona Ct
#D
Ontario, CA 91764
Phone (909) 605-1975

1300 S Eastern Ave
Las Vegas, NV 89104
Phone (702) 385-2242

Organizations & group practices 3

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": "1703635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768521600000",
    "number": "1669241063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3155D SEDONA CT",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917646555",
            "telephone_number": "909-605-1975",
            "fax_number": "909-974-0356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3155D SEDONA CT",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917646555",
            "telephone_number": "909-605-1975",
            "fax_number": "909-974-0356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YIM",
        "first_name": "JOSHUA",
        "middle_name": "HANGUL",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-27",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "36148-TLG",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "1184",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, CA

Sources for this page

Verify at the official NPI Registry.