Jack Son Kim (NPI# 1679808356, PAC ID# 6608906516) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPTOMETRY.
| Nation Provider ID (NPI) | 1679808356 |
| PAC ID by PECOS | 6608906516 |
| Professional Enrollment ID | I20100618000511 |
| Full Name | Jack Son Kim |
| Address |
258 Redwood Shores Pkwy Redwood City CA 94065-1172 |
| Gender | M |
| Medical School | NEW ENGLAND COLLEGE OF OPTOMETRY |
| Graduation Year | 2009 |
| Primary Specialty | OPTOMETRY |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 258 Redwood Shores Pkwy, Redwood City, CA 94065-1172 |
| Street Address |
258 REDWOOD SHORES PKWY |
| City | REDWOOD CITY |
| State | CA |
| Zip | 94065-1172 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael Stephen Oholleran | General Surgery | Sutter Bay Medical Foundation | 290 Redwood Shores Pkwy, Redwood City, CA 94065-1173 |
| Jana M Crain | Diagnostic Radiology | California Advanced Imaging Medical Associates, Inc. | 863 Corriente Point Dr, Redwood City, CA 94065-1284 |
| Manjeet K Mann | Optometry | 303 Twin Dolphin Dr, Suite 122, Redwood City, CA 94065-1417 |
| City | REDWOOD CITY |
| Zip Code | 94065 |
| Specialty | OPTOMETRY |
| City + Specialty | REDWOOD CITY + OPTOMETRY |
Please comment or provide details below to improve the information on Jack Son Kim.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.