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General NPI Number Information
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NPI Number | 1861561243
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Entity Type | Individual
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Provider Name | GENEVIEVE ASHCOM KING M. D.
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Gender | Female
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 02/27/2013
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Provider Practice Location Address
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Address Line | 3636 CASTRO VALLEY BLVD # 10
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-4460
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Country | US
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Telephone | 510-586-0284
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Fax | 510-397-2075
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Provider Business Mailing Address
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Address Line | 21129 DAWE AVE
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-5755
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Country | US
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Telephone | 510-586-0284
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Fax | 510-397-2075
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A69755
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License Number State | CA
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