Individual provider Active NPI

Walter Yim, O.D.

  • Optometrist
  • Huntington Beach, CA
National Provider Identifier
1962531228
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12675T Issued in CA
Practice address
10088 Adams Ave
Huntington Beach, CA 92646-4905
Phone
(714) 962-9377
NPI assigned
Mar 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12675T CA Primary

Addresses

Primary practice location

10088 Adams Ave
Huntington Beach, CA 92646-4905

Mailing address

1873 W Falmouth Ave
Anaheim, CA 92801-7715
Phone (714) 588-1366

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040902001483 CA Practitioner - Optometry 2961478714 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Walter Yim OD a Professional CorporationGroup PAC ID 7517196249, 3 clinicians

Practice addresses (Care Compare)

16450 Bolsa Chica St
Huntington Beach, CA 92649-2603
Phone (714) 840-1366

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12675TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Walter Yim OD a Professional Corporation Optometrist CurrentSince Jan 1, 2013 Accepting new patients
Beachside Optometry Inc. Optometrist PastSince Oct 1, 2001 Accepting new patients
Beachside Optometry Germundsen-Family Partnership Optometrist Past Accepting new patients
Timothy C. Jankowski, OD, Inc Optometrist Past Accepting new patients

Locations

16450 Bolsa Chica St
Huntington Beach, CA 92649
Phone (714) 840-1366

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962531228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1873 W FALMOUTH AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928017715",
            "telephone_number": "714-588-1366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10088 ADAMS AVE",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926464905",
            "telephone_number": "714-962-9377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YIM",
        "first_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12675T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.