Provider Demographics
NPI:1801816467
Name:KIM, SOPHIA JI HYE (MD)
Entity Type:Individual
Prefix:
First Name:SOPHIA
Middle Name:JI HYE
Last Name:KIM
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 1:795 WILLOW RD
Mailing Address - Street 2:118MPD
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-2539
Mailing Address - Country:US
Mailing Address - Phone:650-439-5000
Mailing Address - Fax:650-617-2711
Practice Address - Street 1:795 WILLOW RD
Practice Address - Street 2:118MPD
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-2539
Practice Address - Country:US
Practice Address - Phone:650-493-5000
Practice Address - Fax:650-617-2711
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA60047207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine