Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Samuel C. Kim, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1720379100

Dr. Samuel C. Kim, MD is an Ophthalmology in Upland, California. Graduated from Loma Linda University School of Medicine in 2011, 15 years ago. Practices with Pacific Eye Institute a Medical Group Inc, a 46-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in California, District of Columbia, Ohio and Virginia.

Years since qualifying
15
Trained at
Loma Linda University School of Medicine
Licensed in
CA, DC, OH, VA
In the registry since
2011
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

555 N 13th Ave
Upland, CA 91786-4904
Phone: (909) 982-8846
Fax: (909) 949-3967
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 11370 Anderson St Ste 1800, Loma Linda, CA 92354-3450 — (909) 558-2154
  • 7501 Greenway Center Dr # 300, Greenbelt, MD 20770-3514 — (301) 474-4679

Specialties & licences

Retina Specialist (Ophthalmology) Physician (primary) Taxonomy 207WX0107X · Licence A123812 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (OH)
Ophthalmology Physician Taxonomy 207W00000X · Licence MD042959 (DC)
Ophthalmology Physician Taxonomy 207W00000X · Licence 0101257811 (VA)

Record details

NPI number1720379100
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedApril 20, 2011
Last updated in NPPESJune 24, 2020
Certification dateJune 24, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPHTHALMOLOGY
Medical schoolLOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Graduated 2011 (15 years in practice)
Group practice Pacific Eye Institute A Medical Group Inc — 46 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Upland