Provider Demographics
NPI:1770010936
Name:MIN, LYDIA JIHYE (MD)
Entity type:Individual
Prefix:DR
First Name:LYDIA
Middle Name:JIHYE
Last Name:MIN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9088 RIDGELINE BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2380
Mailing Address - Country:US
Mailing Address - Phone:720-266-6900
Mailing Address - Fax:720-791-9920
Practice Address - Street 1:9088 RIDGELINE BLVD STE 201
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-2380
Practice Address - Country:US
Practice Address - Phone:720-266-6900
Practice Address - Fax:720-791-9920
Is Sole Proprietor?:No
Enumeration Date:2017-05-18
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2021-00311207R00000X
390200000X
CODR.74345207R00000X
IL036157770207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program