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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053415281 NPPES
Kansas MEDICAID 200424060A

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