Provider Demographics
NPI:1053144287
Name:GRACE J. KIM, DO, OSTEOPATHIC CARE, PC
Entity type:Organization
Organization Name:GRACE J. KIM, DO, OSTEOPATHIC CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:JI-HYUN
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:650-262-1004
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty