Michael Sukkyu Kim, O.D.

Optometrist · Vista, CA

Individual Active NPI

NPI number 1164546313

Practice location

134 Grapevine Rd
Vista, CA 92083-4004
Phone
(796) 631-5000

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NPI record

NPI
1164546313
Entity type
Individual (Type 1)
Enumeration date
March 16, 2007
Last updated
July 27, 2021
Certified
July 27, 2021
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Optometrist Primary 152W00000X 12174 CA
Optometrist 152W00000X 286 AK
Specialist 174400000X DA2093 MD
Specialist 174400000X 0618001782 VA

Mailing address

1000 Vale Terrace Dr
Vista, CA 92084-5218
Phone
(760) 631-5000

About Dr. Kim

Michael Sukkyu Kim, O.D. is a healthcare provider registered in the NPI registry with the primary taxonomy Optometrist (code 152W00000X). The practice location is 134 Grapevine Rd, Vista, CA 92083-4004. The NPI number 1164546313 was assigned on March 16, 2007 and the record was last updated on July 27, 2021.

Dr. Kim lists 4 licenses in the registry: #12174 (CA) for Optometrist; #286 (AK) for Optometrist; #DA2093 (MD) for Specialist; #0618001782 (VA) for Specialist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Michael Sukkyu Kim, O.D.?

The NPI number is 1164546313.

What is the phone number of Dr. Kim?

The phone number listed for the practice location is (796) 631-5000.

Where is Dr. Kim located?

134 Grapevine Rd, Vista, CA 92083-4004.

What is the taxonomy code for Dr. Kim?

The primary taxonomy code is 152W00000X – Optometrist; 3 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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