Dr. Elisabeth Keunrok Kim, O.D.
Optometrist in Woodbridge, VA. Individual provider (NPI-1).
NPI number1154469070
StatusActive
Last updated in NPPESAug 27, 2025
Details
- NPI
- 1154469070
- Entity type
- Individual (NPI-1)
- Name
- Dr. Elisabeth Keunrok Kim
- Credential
- O.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 2, 2007
- Certification date
- Aug 27, 2025
- Last updated
- Aug 27, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 0618001424 | VA | Yes |
Practice location
4565 Daisy Reid Ave Ste 108Woodbridge, VA 22192-5671
Phone 703-878-8818 · Fax 703-878-8819
Mailing address
8614 Westwood Center Dr Fl 9Vienna, VA 22182-2442
Phone 703-847-8899 · Fax 571-223-6780
Other practice locations
4160 Merchant Plz
Woodbridge, VA 22192-5085
Woodbridge, VA 22192-5085
Phone 703-878-8818 · Fax 703-878-8819
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