Individual
MR. SAM YONG KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
BOX 555697, CAMP PENDLETON, CA 92055
(619) 961-8745
Mailing address
9115 DILLON DR, LA MESA, CA 91941-4230
(619) 961-8745
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
06/15/2007
Last updated
07/08/2007
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