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1114122645
SAM YONG KIM
CAMP PENDLETON, CA
NPI
1114122645
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2007-06-15
Last Update Date
2007-07-08
Business Address
Mr. SAM YONG KIM IDC
BOX 555697
CAMP PENDLETON, CA 92055
Phone number: 619-961-8745
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Mailing Address
Mr. SAM YONG KIM IDC
9115 DILLON DR
LA MESA, CA 91941-4230
Phone number: 619-961-8745
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