Kim, Se-Ung Samuel
Kim, Se-Ung Samuel is an individual health care provider with primary practice located at 2720 N Harbor Blvd Ste 220 , Fullerton CA 92835-2626. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Reproductive Endocrinology, Allopathic & Osteopathic Physicians / Gynecology. Allopathic & Osteopathic Physicians / Reproductive Endocrinology is his primary health care specialty. Kim, Se-Ung Samuel can be contacted via phone (657) 243-8300.Contact Information
Primary practice address
2720 N Harbor Blvd Ste 220
Fullerton CA 92835-2626
Phone: (657) 243-8300
Fax: (714) 278-4286
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Reproductive Endocrinology | 207VE0102X | A44647 | California |
| Allopathic & Osteopathic Physicians / Reproductive Endocrinology | 207VE0102X | 04-32372 | Kansas |
| Allopathic & Osteopathic Physicians / Gynecology | 207VG0400X | 04-32372 | Kansas |
Profile Details
| NPI number | 1053415281 |
|---|---|
| LBN Legal business name | Kim, Se-Ung Samuel |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 8th, 2006 |
| Last updated | Sep 18th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053415281 | NPPES |
| Kansas | MEDICAID | 200424060A |
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