DR. SAMUEL C. KIM (NPI# 1720379100) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720379100 |
| Entity Type | Individual |
| Full Name | DR. SAMUEL C. KIM |
| Credential | MD |
| Practice Address |
555 N 13th Ave Upland CA 91786-4904 |
| Practice Telephone | 9099828846 |
| Practice Fax Number | 9099493967 |
| Mailing Telephone | 9099828846 |
| Mailing Fax Number | 9099493967 |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2020-06-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207W00000X | Ophthalmology | 0101257811 | VA | Allopathic & Osteopathic Physicians |
| N | 207W00000X | Ophthalmology | MD042959 | DC | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | OH | Student, Health Care | |
| Y | 207WX0107X |
Ophthalmology Specialization: Retina Specialist |
A123812 | CA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 11370 Anderson St Ste 1800, Loma Linda, CA 923543450 | 9095582154 | 9095582180 |
| 7501 Greenway Center Dr # 300, Greenbelt, MD 207703514 | 3014744679 | 3014747182 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063059178 | Samuel Kim | Acupuncturist | 24904 34th Ave, Little Neck, NY 11363-1407 | 2019-12-08 |
| 1952841793 | Samuel Kim | Dentist | 3441 Burritt Way, La Crescenta, CA 91214 | 2017-02-27 |
| 1295107605 | Samuel Kim | Pharmacist | 1001 E Latham Ave Ste P, Hemet, CA 92543-4435 | 2015-10-24 |
| 1902224587 | Samuel M Kim | Internal Medicine | Weill Cornell Medicine Division of Cardiology, 520 East 70th Street, Starr Pavilion 4th Floor, New York, NY 10021-0010 | 2014-04-01 |
| 1174889141 | Samuel Hyojune Kim | Emergency Medicine | One Gustave L Levy Place, Box 1264, Mount Sinai Medical Center Box 1264, New York, NY 10029 | 2012-04-04 |
| 1023310687 | Samuel Sungwon Kim | Pediatrics | 150 N Robertson Blvd Ste 307, Beverly Hills, CA 90211-2145 | 2010-12-02 |
| 1245430206 | Samuel Hun Kim | General Acute Care Hospital | 1420 Crest Vista Dr, Monterey Park, CA 91754-4643 | 2007-07-18 |
| 1992916001 | Samuel I Kim | Dentist | 8811 W Sahara Ave Ste 100, Las Vegas, NV 89117-4813 | 2007-05-24 |
| 1609917285 | Samuel I Kim | Dentist | 21580 Bear Valley Rd, B2-2, Apple Valley, CA 92308-7200 | 2007-02-08 |
| 1184771172 | Samuel Suk Kim | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 676 N Saint Clair St Ste 2320, Chicago, IL 60611 | 2007-01-04 |
| Street Address |
555 N 13TH AVE |
| City | UPLAND |
| State | CA |
| Zip Code | 91786-4904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093744351 | Kamyar Safdari | Anesthesiology | 555 N 13th Ave, Upland, CA 91786-4904 | 2006-06-30 |
| 1669979001 | Sharon Liao | Student in an Organized Health Care Education/Training Program | 555 N 13th Ave, Upland, CA 91786-4904 | 2018-04-11 |
| 1225488612 | Brian Alva | Optometrist | 555 N 13th Ave, Upland, CA 91786-4904 | 2016-06-15 |
| 1083060248 | Visionary Care Anesthesia Associates Inc | Anesthesiology | 555 N 13th Ave, Upland, CA 91786-4904 | 2016-05-06 |
| 1619322898 | Ji-kwan Park | Ophthalmology | 555 N 13th Ave, Upland, CA 91786-4904 | 2016-04-26 |
| 1164809851 | Ryan Gregory Smith | Ophthalmology | 555 N 13th Ave, Upland, CA 91786-4904 | 2015-05-01 |
| 1912249970 | Charisse Chin | Ophthalmology | 555 N 13th Ave, Upland, CA 91786-4904 | 2013-03-18 |
| 1225391725 | Edward Stephen Yung | Ophthalmology | 555 N 13th Ave, Upland, CA 91786-4904 | 2012-06-19 |
| 1679707665 | Mila Jacoba Heersink | Ophthalmology | 555 N 13th Ave, Upland, CA 91786-4904 | 2009-05-06 |
| 1740468263 | Peter D Bekendam | Ophthalmology | 555 N 13th Ave, Upland, CA 91786-4904 | 2008-02-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366093254 | California Clinics, Inc | Physical Medicine & Rehabilitation | 818 N Mountain Ave Ste 102, Upland, CA 91786 | 2019-09-23 |
| 1699231621 | Lynn Keitz | Nurse Practitioner | 360 East 7th Street, Suite D, Upland, CA 91786 | 2019-02-14 |
| 1003386608 | Devin A Lockett | Counselor | 916 N, Mountain Ave. Suite D-1, Upland, CA 91786 | 2018-11-27 |
| 1265900096 | Right Ride | Driver | 1023 West Arrow Hwy Apt A, Upland, CA 91786 | 2018-11-09 |
| 1689142069 | Mike Sedat Safi | Driver | 1023 W Arrow Hwy, Apt A, Upland, CA 91786 | 2018-11-05 |
| 1902373640 | Barsoum Dental | Dentist | 258 E. 9th Street, Upland, CA 91786 | 2018-10-31 |
| 1346736600 | Jennifer Lynn Henshaw | Counselor | Rosewood Counseling Center, 288 W 9th Street, Upland, CA 91786 | 2018-07-10 |
| 1972099521 | Sadeg Aldolaim | Nurse Practitioner | 2086 W Arrow Route, Apt 824, Upland, CA 91786 | 2018-07-06 |
| 1831607332 | Sandra Sun | Pharmacist | 1445 E. Foothill Blvd., Upland, CA 91786 | 2018-01-18 |
| 1841713625 | Dynamic Performance Physical Therapy Inc | Clinic/Center | 2377 W. Foothill Blvd, Ste 20, Upland, CA 91786 | 2017-07-24 |
| Find all providers in zip 91786 | ||||
| Taxonomy Code | 207WX0107X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| Specialization | Retina Specialist |
| An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. |
| Notes: Source: American Society of Retina Specialists, www.asrs.org [1/1/2017: new] - Additional Resources: American Academy of Ophthalmology, www.aao.org. Macula Society, www.maculasociety.org. Retina Society, www.retinasociety.org. Association of University Professors of Ophthalmology, www.aupo.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760031363 | Salehi Retina Institute Inc. | Ophthalmology | 7777 Edinger Ave Ste 234, Huntington Beach, CA 92647-8693 | 2019-09-06 |
| 1669969960 | Vitreo-retinal Medical Group, Inc | Ophthalmology | 1680 E Roseville Pkwy Ste 140, Roseville, CA 95661-3988 | 2018-04-23 |
| 1144733403 | Vitreo-retinal Medical Group Inc | Ophthalmology | 1870 Lassen Blvd Ste B, Yuba City, CA 95993-9455 | 2017-11-08 |
| 1831608264 | Robert Kim | Ophthalmology | 95 Kirkham Avenue, 201, Box 0730, San Francisco, CA 94122 | 2017-09-28 |
| 1538687785 | Thomas Carl Salzano | Ophthalmology | 204 Gainsborough Circle, Folsom, CA 95630 | 2017-09-07 |
| 1992228795 | Central Coast Eye, Inc., A Professional Medical Corporation | Ophthalmology | 628 California Blvd Ste C, San Luis Obispo, CA 93401-2547 | 2017-07-24 |
| 1295013712 | Mukesh Bhogilal Suthar Md Inc | Ophthalmology | 10808 Foothill Blvd Ste 160-203, Rancho Cucamonga, CA 91730-3889 | 2011-08-01 |
| 1790928067 | Bay Area Retina Associates,medical Group | Ophthalmology | 1460 N Camino Alto Ste 109, Vallejo, CA 94589-2567 | 2009-04-15 |
| 1083857353 | Bay Area Retina Associates,medical Group | Ophthalmology | 15051 Hesperian Blvd Ste D, San Leandro, CA 94578-3536 | 2009-04-15 |
| 1942489356 | Ash Pirouz | Ophthalmology | 301 W Bastanchury Rd Ste 285, Fullerton, CA 92835-3432 | 2007-11-01 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. SAMUEL C. KIM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.