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
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.
Title
Owner
Phone
(909) 982-9366

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
Kaiser Permanente Panorama City Medical Center119 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

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.