Provider Demographics
NPI:1558943381
Name:KIM, GRACE JIHYUN (DO)
Entity type:Individual
Prefix:DR
First Name:GRACE
Middle Name:JIHYUN
Last Name:KIM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 SUNNYVALE SARATOGA RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-4597
Mailing Address - Country:US
Mailing Address - Phone:650-262-1004
Mailing Address - Fax:
Practice Address - Street 1:1560 SUNNYVALE SARATOGA RD STE 100
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-4597
Practice Address - Country:US
Practice Address - Phone:650-262-1004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A22886204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM