Joanne J. Kim OD Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

13418 Issued in CA

Legal business name

JOANNE J. KIM OD INC

Practice address

14147 Pipeline Ave
Chino, CA 91710-5618

Phone

(909) 628-0300

NPI assigned

Jan 21, 2015

Organization subpart

No

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

Authorized official

Name

Joanne Ji Yun Kim

Title

Ceo/OD

Phone

(909) 628-0300

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1421798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714003200000",
    "number": "1679962179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14147 PIPELINE AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917105618",
            "telephone_number": "909-628-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14147 PIPELINE AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917105618",
            "telephone_number": "909-628-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOANNE J. KIM OD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-21",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_middle_name": "JI YUN",
        "authorized_official_title_or_position": "CEO/OD",
        "authorized_official_telephone_number": "909-628-0300"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Chino, CA
• Providers in Chino, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.