Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Grace Kim

Individual provider Optometrist · NPI 1770161465

Grace Kim is an Optometry in Los Angeles, California. Graduated from Illinois College of Optometry at Chicago in 2021, 5 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
5
Trained at
Illinois College of Optometry at Chicago
Licensed in
CA
In the registry since
2021
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Practice location Address checks out

11540 Santa Monica Blvd Ste 202
Los Angeles, CA 90025-7905
Phone: (310) 473-5464
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 16111 Plummer St, North Hills, CA 91343-2036 — (818) 891-7711

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 35031TLG (CA)

Record details

NPI number1770161465
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 1, 2021
Last updated in NPPESJune 23, 2026
Certification dateJune 23, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Graduated 2021 (5 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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