DR. EUGENE CHONGKON KIM (NPI# 1083813315) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083813315 |
| Entity Type | Individual |
| Full Name | DR. EUGENE CHONGKON KIM |
| Credential | O.D. |
| Practice Address |
7379 Indiana Ave Riverside CA 92504-4547 |
| Practice Telephone | 9516847822 |
| Practice Fax Number | 9519778075 |
| Mailing Telephone | 9516847822 |
| Mailing Fax Number | 9519778075 |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2017-02-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 13309 | CA | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE GROUP PTAN | CD249A | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477825438 | Eugene Y Kim | Radiology | 1613 Hill St, White Oak, PA 15131-2119 | 2012-02-06 |
| 1912225673 | Eugene Kim | Pain Medicine | 4650 Sunset Blvd, Ms #3, Children's Hospial Los Angeles, Dept of Anesthesia, Los Angeles, CA 90027 | 2010-05-05 |
| 1609051838 | Eugene Duejin Kim | Dentist | 5861 Beach Blvd, Buena Park, CA 90621-2021 | 2008-01-07 |
| 1346277969 | Eugene H Kim | Internal Medicine | 9378 Forestwood Ln, Suite E, Manassas, VA 20110-4741 | 2006-06-27 |
| 1831157049 | Eugene Young Kim | Podiatrist | 3117 Ditmars Blvd, Astoria, NY 11105-2300 | 2006-05-04 |
| 1255390522 | Eugene I. Kim | Dentist | 9201 N 29th Ave, Suite 33, Phoenix, AZ 85051-3468 | 2006-03-23 |
| 1679186324 | Eugene Kim | Student in an Organized Health Care Education/Training Program | 240 E Huron St Ste 1-200, Chicago, IL 60611-2909 | 2020-08-24 |
| 1114585239 | Eugene Heejin Kim | Student in an Organized Health Care Education/Training Program | 1251 S Cedar Crest Blvd Ste 202a, Allentown, PA 18103-6214 | 2019-06-04 |
| 1710541982 | Eugene Kim | Orthopaedic Surgery | 1 Boston Medical Ctr Pl, Boston, MA 02118-2908 | 2019-04-23 |
| 1588151641 | Eugene Kim | Student in an Organized Health Care Education/Training Program | 800 Washington St, Boston, MA 02111-1552 | 2018-04-15 |
| Street Address |
7379 INDIANA AVE |
| City | RIVERSIDE |
| State | CA |
| Zip Code | 92504-4547 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164579918 | Cheryl Marie Everitt | Optometrist | 7379 Indiana Ave, Suite 101, Riverside, CA 92504-4547 | 2007-01-04 |
| 1538511837 | Mallory Adele Kennedy | Optometrist | 7379 Indiana Ave, Riverside, CA 92504-4547 | 2016-07-11 |
| 1215161815 | 20/20 Vision Associates Optometry, Inc. | Optometrist | 7379 Indiana Ave, Riverside, CA 92504-4547 | 2009-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417573676 | Chloe Ivana Licon | Marriage & Family Therapist | New Beginnings Residential Treatment Facilities, 2900 Adams St, Riverside, CA 92504 | 2020-06-23 |
| 1720628993 | Palm Lily LLC | Non-emergency Medical Transport (VAN) | 2900 Adams Street Suite A435, Riverside, CA 92504 | 2020-01-15 |
| 1538630959 | Just for Kids Pediatric Dentistry Raymond Wang | Dentist | 7071 Indiana Ave, Riverside, CA 92504 | 2018-12-11 |
| 1477047835 | Deborah Kay Allen | Peer Specialist | 6939 Morningside Ave, Riverside, CA 92504 | 2018-06-19 |
| 1255833794 | Adiana Loya | Student in an Organized Health Care Education/Training Program | 7550 Orchard St Apt #58, Riverside, CA 92504 | 2018-03-01 |
| 1023524162 | Chiara Heyer | Counselor | 4130 Adams St Ste B, Riverside, CA 92504 | 2017-12-27 |
| 1801313408 | Gustavo Gallo Avelar | Behavioral Analyst | 4125 Rucker Ln, Riverside, CA 92504 | 2017-08-24 |
| 1891226205 | Susana Herold | Assistant Behavior Analyst | 17460 Krameria Ave, Riverside, CA 92504 | 2017-03-27 |
| 1710356167 | Erandi Portugal | Counselor | 6711 Alrington Avenue, Riverside, CA 92504 | 2015-09-16 |
| 1548636012 | Candace Lauren Bynder | Counselor | 6711 Arlington Avenue, Riverside, CA 92504 | 2015-08-19 |
| Find all providers in zip 92504 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194203398 | Penn Tran Od, Inc | Optometrist | 1299 University Ave Ste 103, Riverside, CA 92507-7236 | 2018-07-31 |
| 1679020283 | Pritesh Patel | Optometrist | 4030 Madison St, Riverside, CA 92504-2642 | 2016-09-01 |
| 1447644893 | Richard P Bozner Od Inc | Optometrist | 4212 Market St, Riverside, CA 92501-3516 | 2015-03-24 |
| 1770976987 | Retina Institute of California | Optometrist | 6906 Brockton Ave, Ste. 6, Riverside, CA 92506-4090 | 2015-03-12 |
| 1902295132 | Oxygen Optometry, Inc | Optometrist | 2712 Canyon Springs Pkwy, Suite A4, Riverside, CA 92507-0938 | 2015-01-12 |
| 1164837183 | Al Vincent D. Romero, O.d. Inc. | Optometrist | 9496 Magnolia Ave Ste 102, Riverside, CA 92503-3733 | 2014-06-27 |
| 1275808115 | Duong D Nguyen, Inc | Optometrist | 5051 Canyon Crest Dr Ste 102, Riverside, CA 92507-6035 | 2012-03-10 |
| 1750679171 | Jessica Duong | Optometrist | 4294 Riverwalk Pkwy, Suite 204, Riverside, CA 92505-8508 | 2011-07-19 |
| 1508185554 | Jerry P Gibson | Optometrist | 3140 White Oak Cr, Riverside, IA 52327 | 2010-05-28 |
| 1023248770 | Dr Harold Krajian Od Inc | Optometrist | 9496 Magnolia Ave, 102, Riverside, CA 92503-3733 | 2009-07-15 |
| Find all providers in RIVERSIDE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.