Michael G Kiyomoto OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT7506TPA Issued in CA

Legal business name

MICHAEL G KIYOMOTO OD

Practice address

2035 San Pablo Ave
Berkeley, CA 94702-1613

Phone

(510) 843-0721

Fax

(510) 843-0721

NPI assigned

Jun 10, 2009

Last updated

Jun 10, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael G Kiyomoto, ODNPI 1225119209

Title

Owner

Phone

(510) 843-0721

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael G Kiyomoto, OD

  • Optometrist
  • Berkeley, CA
  • NPI 1225119209
  Authorized official Same address or phone

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

{
    "created_epoch": "1244592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244592000000",
    "number": "1730315201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2035 SAN PABLO AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947021613",
            "telephone_number": "510-843-0721",
            "fax_number": "510-843-0721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 SAN PABLO AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947021613",
            "telephone_number": "510-843-0721",
            "fax_number": "510-843-0721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL G KIYOMOTO OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-10",
        "last_updated": "2009-06-10",
        "status": "A",
        "authorized_official_last_name": "KIYOMOTO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-843-0721",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT7506TPA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Meyers, LCSW, MSW, MPH
• Daniel Christopher Meza
• Mark Mezak
• Guy Micco, M.D.
• Michael Clark Marriage and Family Therapy, Inc
• Michael Nian Peng Shi, L.Ac., PH.D. (Nian Peng Shi, L.Ac.,Ph.D.)
• Nathan Michael, M.A.
• Bronwyn Gay Michaelis, LAC
• Thomas Christoph Michahelles, LMFT
• Lauren Michalsen

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2009; 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.