Lee, Samuel Shin Kwon

Lee, Samuel Shin Kwon is an sole proprietor health care provider with primary practice located at 18400 Us Highway 18 , Apple Valley CA 92307-2306. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Lee, Samuel Shin Kwon can be contacted via phone (760) 242-3939.

Contact Information

Primary practice address
18400 Us Highway 18 Apple Valley CA 92307-2306
Phone: (760) 242-3939
Fax: (760) 242-3232
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 110101 Missouri
Allopathic & Osteopathic Physicians / Urology 208800000X 060213 Georgia
Allopathic & Osteopathic Physicians / Urology 208800000X A49819 California

Profile Details

NPI number 1194772418
LBN Legal business name Lee, Samuel Shin Kwon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 30th, 2006
Last updated Jun 15th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194772418 NPPES
Missouri Other 785000022 MEDICARE PART B

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