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NPI Code Detail

MEDICARE: JAMES EARL KING JR.

MEDICARE: JAMES EARL KING JR.
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
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1699639252
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES EARL KING JR.
Provider Business Mailing Address
First Line : 12390 GOLDEN STATE BLVD
Second Line :
City : MADERA
State : CA
Zip : 93637-9156
Country : US
Telephone Number : 559-660-4600
Fax Number :
Provider Business Practice Location Address
First Line : 12390 GOLDEN STATE BLVD
Second Line :
City : MADERA
State : CA
Zip : 93637-9156
Country : US
Telephone Number : 559-660-4600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2025
Last Update Date : 12/09/2025

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