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General NPI Number Information
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NPI Number | 1679067532
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Entity Type | Organization
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Legal Business Name | CATHERINE KIM OPTOMETRY
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Dates
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Enumeration Date | 06/14/2018
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Last Update Date | 06/14/2018
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Provider Practice Location Address
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Address Line | 735 S FIGUEROA ST STE 137
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City | LOS ANGELES
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State | CA
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Zip | 90017-2574
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Country | US
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Telephone | 213-622-0257
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Fax | 213-629-7432
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Provider Business Mailing Address
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Address Line | 1219 N COLUMBUS AVE APT 108
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City | GLENDALE
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State | CA
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Zip | 91202-3846
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Country | US
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Telephone | 818-321-6594
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Fax | 213-629-7432
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Authorized Official
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Title or Position | PRESIDENT
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Name | CATHERINE KIM
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Credential | OD
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Telephone | 213-622-0257
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 14397
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License Number State | CA
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