Provider Demographics
NPI:1306131925
Name:KIM, JUDY YOO JIN (MD)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:YOO JIN
Last Name:KIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JUDY
Other - Middle Name:
Other - Last Name:CHOI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1000 FRANKLIN PKWY
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-1922
Mailing Address - Country:US
Mailing Address - Phone:650-358-7000
Mailing Address - Fax:
Practice Address - Street 1:401 BURGESS DR STE A
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-3476
Practice Address - Country:US
Practice Address - Phone:650-800-3365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-10
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA122885207Q00000X
IL036146774207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine