Individual
DR. HETTY YI KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
14914 SHERMAN WAY, VAN NUYS, CA 91405-2113
(818) 787-2020
(818) 787-8652
Mailing address
14914 SHERMAN WAY, VAN NUYS, CA 91405-2113
(818) 787-2020
(818) 787-8652
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
12390T
CA
152WC0802X
Corneal and Contact Management Optometrist
12390T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OPT12390T
OPTOM LICENSE
CA
Enumeration date
02/27/2007
Last updated
02/11/2022
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