Jack Son Kim, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

13848 Issued in CA

Practice address

5832 Beach Blvd Unit 109
Buena Park, CA 90621-5500

Phone

(714) 228-1888

Fax

(714) 676-8308

NPI assigned

Oct 13, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: jkim@ecmc.intellechartdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Eyecare Medical Corporation

  • Ophthalmology Physician
  • Buena Park, CA
  • NPI 1427016120

  Optometrist

  Medicare reassignment NPD
• Eyecare Medical Corporation

  • Ophthalmology Physician
  • Artesia, CA
  • NPI 1932580198

  Optometrist

  NPD
• Visionone Optometry Eye Care, Inc

  • Optometrist
  • Redwood City, CA
  • NPI 1710332044
  NPD
• Jill S. Chen, O.D., Inc.

  • Optometrist
  • Cerritos, CA
  • NPI 1518366582
  NPD (past)
• Lasik Eyecare Medical Corporation

  • Ophthalmology Physician
  • Buena Park, CA
  • NPI 1568965499
  NPD (past)

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

{
    "created_epoch": "1255392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1679808356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6495 SAIPAN ST",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906305620",
            "telephone_number": "626-388-7391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5832 BEACH BLVD UNIT 109",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906215500",
            "telephone_number": "714-228-1888",
            "fax_number": "714-676-8308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19038 Norwalk Blvd",
            "address_purpose": "LOCATION",
            "city": "Artesia",
            "state": "CA",
            "postal_code": "907017032",
            "country_code": "US",
            "telephone_number": "562-653-9500",
            "fax_number": "562-653-9513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JACK",
        "middle_name": "SON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-13",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hoon Kim, ACUPUNCTURIST
• Hun Hee Kim, L'AC
• Hyeri Kim, L.AC.
• Inja Kim, M.D.
• Insoo Kim, DDS
• Jaewon Kim
• Jay Kim
• Jennifer Kim
• Jin Ri Kim
• Jong Kap Kim, L.AC, PH.D

• Optometrist in Buena Park, CA
• Providers in Buena Park, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.