Individual
LYDIA R KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7373 WEST LN STE 355, STOCKTON, CA 95210-3377
(209) 476-2166
Mailing address
600 HIGHLAND AVE, MADISON, WI 53792-0001
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
64429
WI
207N00000X
Dermatology Physician
Primary
A150150
CA
Other
Enumeration date
04/05/2013
Last updated
12/17/2021
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