NPIMap

Organization Active NPI

Jimmy K So OD Inc

  • Optometrist
  • Upland, CA
National Provider Identifier
1790047660
Registry record updated Jun 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
JIMMY K SO OD INC
Practice address
1261 W Foothill Blvd
Suite 8
Upland, CA 91786-8018
Phone
(909) 982-9366
Fax
(909) 982-2477
NPI assigned
Jun 15, 2012
Last updated
Jun 15, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2012

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

Authorized official

Name
Jimmy K So, O.D.NPI 1548233059
Title
Owner
Phone
(909) 982-9366

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1261 W Foothill Blvd
Suite 8
Upland, CA 91786-8018

Mailing address

1261 W Foothill Blvd
Suite 8
Upland, CA 91786-8018
Phone (909) 982-9366

National Provider Directory

National Provider Directory
Tax ID family
Catholic Charities119 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 16

Locations

1261 W Foothill Blvd
Ste 8
Upland, CA 91786
Phone (909) 982-9366

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1339718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339718400000",
    "number": "1790047660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1261 W FOOTHILL BLVD",
            "address_2": "SUITE 8",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917868018",
            "telephone_number": "909-982-9366",
            "fax_number": "909-982-2477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1261 W FOOTHILL BLVD",
            "address_2": "SUITE 8",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917868018",
            "telephone_number": "909-982-9366",
            "fax_number": "909-982-2477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIMMY K SO OD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-15",
        "last_updated": "2012-06-15",
        "status": "A",
        "authorized_official_last_name": "SO",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-982-9366",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2012; 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.