Active NPI
Mihwa Kim, O.D.
- Optometrist
- Oakland, CA
National Provider Identifier
1932277316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 10498
- Practice address
- 2633 Telegraph Ave Ste #106
Oakland, CA 94612-1744 - Phone
- (510) 451-4900
- NPI assigned
- Dec 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 10498 | CA | Primary |
Addresses
Primary practice location
2633 Telegraph Ave Ste #106
Oakland, CA 94612-1744
Mailing address
2633 Telegraph Ave Ste #106
Oakland, CA 94612-1744
Phone (510) 451-4900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0104980 | Medicaid | CA |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110715000357 | CA | Practitioner - Optometry | 4789852898 | Practice locations: Oakland, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10498 | CA | MD | Hearing Instrument Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464912000000",
"number": "1932277316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2633 TELEGRAPH AVE STE #106",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946121744",
"telephone_number": "510-451-4900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2633 TELEGRAPH AVE STE #106",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946121744",
"telephone_number": "510-451-4900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "MIHWA",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-01",
"last_updated": "2016-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "10498",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0104980",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2016; 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.