SE-Ung Samuel Kim, M.D.

Primary specialty

Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X

License

A44647 Issued in CA

Practice address

2720 N Harbor Blvd Ste 220
Fullerton, CA 92835-2626

Phone

(657) 243-8300

Fax

(714) 278-4286

NPI assigned

Sep 8, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1053415281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 N HARBOR BLVD STE 220",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928352626",
            "telephone_number": "657-243-8300",
            "fax_number": "714-278-4286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 N HARBOR BLVD STE 220",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928352626",
            "telephone_number": "657-243-8300",
            "fax_number": "714-278-4286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SE-UNG",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-08",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "CA",
            "license": "A44647",
            "primary": true
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "KS",
            "license": "04-32372",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "KS",
            "license": "04-32372",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200424060A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul Taehyung Kim, DDS
• Pius J. Kim, M.D.
• Rachel Kim, DPT
• Rachel Myonghui Kim
• Richard Kim
• Sean Seokwon Kim, PHARMD
• Shalimar Kim
• Silvia Kim
• Simon C Kim, L. AC.
• Sooin Kim

• Reproductive Endocrinology Physician in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Reproductive Endocrinology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.