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General NPI Number Information
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NPI Number | 1730665795
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Entity Type | Individual
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Provider Name | LAURA KING DO
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Gender | Female
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Dates
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Enumeration Date | 07/12/2018
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Last Update Date | 10/12/2021
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Provider Practice Location Address
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Address Line | 7345 MEDICAL CENTER DR STE 420
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City | WEST HILLS
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State | CA
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Zip | 91307-1964
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Country | US
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Telephone | 818-251-9750
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Fax |
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Provider Business Mailing Address
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Address Line | 5767 W CENTURY BLVD STE 400
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City | LOS ANGELES
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State | CA
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Zip | 90045-5631
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Country | US
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Telephone | 310-301-8771
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A18012
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License Number State | CA
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