Provider Demographics
NPI:1477689891
Name:KIM, LINDA UIN SOO (MD)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:UIN SOO
Last Name:KIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 ORINDA WAY STE C-532
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-2530
Mailing Address - Country:US
Mailing Address - Phone:415-286-5915
Mailing Address - Fax:
Practice Address - Street 1:21 ORINDA WAY STE C-532
Practice Address - Street 2:
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-2530
Practice Address - Country:US
Practice Address - Phone:415-286-5915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAL-2244752084P0800X
CAA1113312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry