Walter S Kim, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT-6975T Issued in CA

Practice address

237 N Western Ave
Los Angeles, CA 90004-4107

Phone

(323) 469-1929

Fax

(323) 469-1920

NPI assigned

Jul 28, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Western Optometric Center Inc

  • Optometrist
  • Los Angeles, CA
  • NPI 1942982624
  NPD (past)

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221696000000",
    "number": "1821098096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 N WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900044107",
            "telephone_number": "323-469-1929",
            "fax_number": "323-469-1920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 N WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900044107",
            "telephone_number": "323-469-1929",
            "fax_number": "323-469-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "WALTER",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2008-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT-6975T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0069750",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tina Kim
• Uisong Kim
• Victoria Kim, LCSW
• Virginia Kim, M.D.
• Walter J Kim I, M.D.
• Whal Lan Kim, ACSW
• William Kim, PHARMD
• William Dae Won Kim, DDS
• William June-Ki Kim, L.AC.
• Won Kim

• Optometrist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.