NPIMap

Organization Active NPI

Lily H Kim OD a Professional Corporation

  • Optometrist
  • Santa Clara, CA
National Provider Identifier
1982801254
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10347T Issued in CA
Legal business name
LILY H KIM OD A PROFESSIONAL CORPORATION
Practice address
2366 El Camino Real
Suite 5
Santa Clara, CA 95050-4070
Phone
(408) 246-5858
Fax
(408) 246-5717
NPI assigned
Jun 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

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

Authorized official

Name
Dr. Lily H Kim, OD
Title
President
Phone
(408) 246-5858

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 10347T CA Primary

Addresses

Primary practice location

2366 El Camino Real
Suite 5
Santa Clara, CA 95050-4070

Mailing address

2366 El Camino Real
Suite 5
Santa Clara, CA 95050-4070
Phone (408) 246-5858

Other names 1

  • Eyetopia Optometry Doing business as

National Provider Directory

National Provider Directory

Locations

2344 El Camino Real
Ste 118
Santa Clara, CA 95050
Phone (408) 246-5858

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576108800000",
    "number": "1982801254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2366 EL CAMINO REAL",
            "address_2": "SUITE 5",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950504070",
            "telephone_number": "408-246-5858",
            "fax_number": "408-246-5717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2366 EL CAMINO REAL",
            "address_2": "SUITE 5",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950504070",
            "telephone_number": "408-246-5858",
            "fax_number": "408-246-5717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LILY H KIM OD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-29",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "LILY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-246-5858",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10347T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eyetopia Optometry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eyetopia Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Clara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.