Individual provider · Type 1 NPI
Young S. Kim
Eyewear Supplier · San Diego, CA
NPI number
1114802659
Active
Practice location
4619 Convoy St # A6
San Diego, CA 92111-2318
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Eyewear Supplier Primary | 332H00000X | RDO70566 (CA) |
Eyewear Supplier: An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
About NPI 1114802659
Young S. Kim's National Provider Identifier is 1114802659, issued on Aug 6, 2025. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in San Diego, CA. The record was last updated on Aug 6, 2025.