Provider Demographics
NPI:1477352755
Name:MINT OPTOMETRY ARCADIA
Entity type:Organization
Organization Name:MINT OPTOMETRY ARCADIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:630-903-8988
Mailing Address - Street 1:29 E HUNTINGTON DR STE B
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-3210
Mailing Address - Country:US
Mailing Address - Phone:626-303-1888
Mailing Address - Fax:
Practice Address - Street 1:29 E HUNTINGTON DR STE B
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3210
Practice Address - Country:US
Practice Address - Phone:626-303-1888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty