Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lydia R Kim, MD

Individual provider Dermatology Physician · NPI 1801139068

Lydia R Kim, MD is a Dermatology in Stockton, California. Graduated from University of Wisconsin School of Medicine in 2012, 14 years ago. Practices with Providence Medical Institute, a 336-clinician group and accepts Medicare assignment. Licensed in California and Wisconsin.

Years since qualifying
14
Trained at
University of Wisconsin School of Medicine
Licensed in
CA, WI
In the registry since
2013
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

7373 W Ln Ste 355
Stockton, CA 95210-3377
Phone: (209) 476-2166
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence A150150 (CA)
Dermatology Physician Taxonomy 207N00000X · Licence 64429 (WI)

Record details

NPI number1801139068
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 5, 2013
Last updated in NPPESDecember 17, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolUNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
Graduated 2012 (14 years in practice)
Group practice Providence Medical Institute — 336 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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