Paul Kim Optometry Apple Valley a Professional Corporation

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

PAUL KIM OPTOMETRY APPLE VALLEY A PROFESSIONAL CORPORATION

Practice address

19071 Bear Valley Rd Ste 3
Apple Valley, CA 92308-2718

Phone

(760) 452-3990

NPI assigned

Sep 30, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Paul Kim, OD

Title

President

Phone

(630) 903-8988

Specialties & licenses 1

Addresses

Other names 1

• Apple Valley Family Eye Care Optometry Other name

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

{
    "created_epoch": "1727654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727654400000",
    "number": "1750109567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19071 BEAR VALLEY RD STE 3",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923082718",
            "telephone_number": "760-452-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19071 BEAR VALLEY RD STE 3",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923082718",
            "telephone_number": "760-452-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL KIM OPTOMETRY APPLE VALLEY A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-30",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-903-8988",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Apple Valley Family Eye Care Optometry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rama T Pathi, MD
• Amber Patterson
• Ashley Patterson
• Brian Patterson, MD, MPH
• Paul J Wisniewski DO Inc
• Stephanie Pavlik, DNP, APRN, FNP-C
• Jackie Kay Pavloski-Carter, MS,CCC,SLP
• Gloria Anne Peak, FNP
• Trisa Marie Pederson
• Cynthia Edith Pedroza

• Optometrist in Apple Valley, CA
• Providers in Apple Valley, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.