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NPI Code Detail

MEDICARE: SUE KIM MD

MEDICARE: SUE KIM MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianA79478CA
22084P0800XPsychiatry PhysicianA79478CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164509097
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUE KIM MD
Provider Business Mailing Address
First Line : PO BOX 276950
Second Line :
City : SACRAMENTO
State : CA
Zip : 95827-6950
Country : US
Telephone Number : 650-614-3253
Fax Number :
Provider Business Practice Location Address
First Line : 795 EL CAMINO REAL
Second Line :
City : PALO ALTO
State : CA
Zip : 94301-2302
Country : US
Telephone Number : 650-614-3253
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2006
Last Update Date : 04/17/2026

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Directions to “ SUE KIM MD” Practice Location

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