Organization
SAMUEL D VAN KIRK MD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL D VAN KIRK MD (OWNER)
(530) 247-0270
Entity
Organization
Contact information
Practice address
2139 AIRPARK DR, REDDING, CA 96001-2433
(530) 247-0270
(530) 247-0271
Mailing address
2139 AIRPARK DR, REDDING, CA 96001-2433
(530) 247-0270
(530) 247-0271
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A86026
MEDICAL LICENSE
CA
05
—
GR0094810
—
CA
Enumeration date
03/30/2021
Last updated
03/30/2021
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