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General NPI Number Information
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NPI Number | 1801816467
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Entity Type | Individual
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Provider Name | SOPHIA JI HYE KIM M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 01/28/2008
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Provider Practice Location Address
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Address Line | 795 WILLOW RD 118MPD
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City | MENLO PARK
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State | CA
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Zip | 94025-2539
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Country | US
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Telephone | 650-493-5000
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Fax | 650-617-2711
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Provider Business Mailing Address
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Address Line | 795 WILLOW RD 118MPD
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City | MENLO PARK
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State | CA
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Zip | 94025-2539
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Country | US
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Telephone | 650-439-5000
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Fax | 650-617-2711
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | A60047
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License Number State | CA
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