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NPI Code Detail

MEDICARE: DR. ANDREW T. KING MEDICAL DOCTOR

MEDICARE: DR. ANDREW T. KING MEDICAL DOCTOR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085B0100XBody Imaging PhysicianG81770CA
22085N0904XNuclear Radiology PhysicianG81770CA
32085R0202XDiagnostic Radiology PhysicianG81770CA
42085R0204XVascular & Interventional Radiology PhysicianG81770CA
52085U0001XDiagnostic Ultrasound PhysicianG81770CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588653554
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREW T. KING MEDICAL DOCTOR
Provider Business Mailing Address
First Line : 223 N 1ST AVE
Second Line : SUITE #201
City : ARCADIA
State : CA
Zip : 91006-7089
Country : US
Telephone Number : 626-698-7246
Fax Number : 626-447-1058
Provider Business Practice Location Address
First Line : 100 W CALIFORNIA BLVD
Second Line :
City : PASADENA
State : CA
Zip : 91105-3010
Country : US
Telephone Number : 626-397-5139
Fax Number : 626-447-1058
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2005
Last Update Date : 10/21/2014

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