Provider Demographics
NPI:1073784492
Name:RHEE, SOO SHIN (MD)
Entity Type:Individual
Prefix:DR
First Name:SOO
Middle Name:SHIN
Last Name:RHEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:DEPT 34929
Mailing Address - Street 2:P.O. BOX 39000
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94139-0001
Mailing Address - Country:US
Mailing Address - Phone:925-952-2828
Mailing Address - Fax:925-952-2850
Practice Address - Street 1:5820 STONERIDGE MALL RD
Practice Address - Street 2:SUITE 101
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-3274
Practice Address - Country:US
Practice Address - Phone:925-224-0720
Practice Address - Fax:925-224-0722
Is Sole Proprietor?:No
Enumeration Date:2008-03-13
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ44402207RE0101X
CAA115444207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA115444OtherLICENSE
CA115444OtherLICENSE