Kyu Hwan Jang, ABO

Primary specialty

OpticianTaxonomy code 156FX1800X

License

162590

Practice address

621 S Western Ave Ste 214
Los Angeles, CA 90005-3042

Phone

(213) 389-1001

Fax

(213) 389-1002

NPI assigned

Feb 27, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Boaz Eyewear Opt,Inc

  • Optician
  • Los Angeles, CA
  • NPI 1881330876
  NPD
• Paul Kim, O.D., a Professional Corporation

  dba MASQ Optometry

  • Optometrist
  • Los Angeles, CA
  • NPI 1407563661
  NPD

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

{
    "created_epoch": "1614384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614384000000",
    "number": "1679167878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S WESTERN AVE STE 214",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900053042",
            "telephone_number": "213-389-1001",
            "fax_number": "213-389-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S WESTERN AVE STE 214",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900053042",
            "telephone_number": "213-389-1001",
            "fax_number": "213-389-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANG",
        "first_name": "KYU",
        "middle_name": "HWAN",
        "credential": "ABO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-27",
        "last_updated": "2021-02-27",
        "certification_date": "2021-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": "162590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ABO",
            "identifier": "162590",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jae Soo Jang, AC
• Jiah Jang, D.O.
• Jisoon Jang, NP
• Jun Hee Jang
• Jung Yun Jang, PH.D.
• Leslie Dea Jang, ACSW
• Marcus Jang, MS, NP
• Michelle Jang, BCBA
• Michelle Jang, DDS
• Miyoung Jang

• Optician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Optician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2021; 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.