MR. SAM YONG KIM IDC
NPI 1114122645
Military Health Care Provider - Independent Duty Corpsman in Camp Pendleton, CA

Q: What is Sam Kim's NPI number?

The NPI number for Sam Kim is 1114122645. It was assigned to this individual provider in the NPPES registry on June 15, 2007.

Q: What is Sam Kim's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

Q: When was this NPI record last updated?

The NPPES record for Sam Kim was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 15, 2007

BOX 555697, CAMP PENDLETON, CA 92055(619) 961-8745 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mr. Sam Yong Kim Idc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. SAM YONG KIM IDC (NPI 1114122645) is an individual independent duty corpsman provider in Camp Pendleton, California and active in the NPI registry since June 2007.

NPPES Registry Identity

NPI1114122645

Entity TypeIndividualMale

Primary Taxonomy1710I1002X

Provider Legal NameMR. SAM YONG KIMCredential: IDC

Location AddressBOX 555697Camp Pendleton, CA 92055

Mailing Address9115 Dillon DrLa Mesa, CA 91941-4230 · (619) 961-8745

Phone(619) 961-8745

Sole ProprietorYes

Enumeration DateJune 15, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1114122645 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMilitary Health Care Provider · Independent Duty CorpsmanOther Service Providers

Taxonomy Code1710I1002X

Definition

A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.

BOX 555697, Camp Pendleton, CA 92055

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sam Kim's NPI number?

The NPI number for Sam Kim is 1114122645. It was assigned to this individual provider in the NPPES registry on June 15, 2007.

Where is Sam Kim located?

Sam Kim practices at Box 555697, Camp Pendleton, CA 92055. The listed phone number is (619) 961-8745.

What is Sam Kim's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

When was this NPI record last updated?

The NPPES record for Sam Kim was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.