Individual
DR. GRACE S KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1660 SAN CARLOS AVE, SAN CARLOS, CA 94070-2022
(650) 759-9122
Mailing address
220 STANDIFORD AVE STE F, MODESTO, CA 95350-1159
(209) 579-5628
(209) 579-5637
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
A76484
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A76484
MEDICAL LICENSE
CA
Enumeration date
07/20/2006
Last updated
07/27/2021
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