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General NPI Number Information
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NPI Number | 1093914921
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Entity Type | Organization
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Legal Business Name | WESLEY A KING MD A PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 07/11/2007
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Last Update Date | 03/26/2019
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Provider Practice Location Address
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Address Line | 8436 W 3RD ST STE 800
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City | LOS ANGELES
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State | CA
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Zip | 90048-4100
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Country | US
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Telephone | 310-385-1918
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Fax | 323-433-7106
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Provider Business Mailing Address
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Address Line | 122 SHELDON ST
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City | EL SEGUNDO
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State | CA
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Zip | 90245-3915
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Country | US
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Telephone | 310-322-4278
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Fax | 310-570-2231
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Authorized Official
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Title or Position | PRESIDENT
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Name | WESLEY A KING
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Credential | MD
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Telephone | 310-385-1918
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | A42379
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License Number State | CA
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