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General NPI Number Information
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NPI Number | 1881882223
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Entity Type | Individual
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Provider Name | JULIE CHEON KIM O.D.
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Gender | Female
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Dates
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Enumeration Date | 10/10/2007
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 7562 CENTER AVE
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-3002
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Country | US
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Telephone | 714-372-7525
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 54851
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City | IRVINE
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State | CA
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Zip | 92619-4851
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 046.010036
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 14387T
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License Number State | CA
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