Healthcare Provider Details

I. General information

NPI: 1821494162
Provider Name (Legal Business Name): YU NA KIM M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2014
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 PARNASSUS AVE
SAN FRANCISCO CA
94143-2202
US

IV. Provider business mailing address

1353 DORCHESTER AVE
DORCHESTER MA
02122-2932
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-2350
  • Fax:
Mailing address:
  • Phone: 617-288-3230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberC196860
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberC196860
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC196860
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number276295
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: