MEDICARE: DR. JOHN F. KING AU.D.

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
1	231H00000X	Audiologist	AU2684	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AU2684	OTHER	CA	AUDIOLOGY STATE LICENSE

General Provider Information

NPI Number	:	1194055715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN F. KING AU.D.

Provider Business Mailing Address
First Line	:	PO BOX 177002
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92177-0002
Country	:	US
Telephone Number	:	619-838-8929
Fax Number	:	619-838-8929

Provider Business Practice Location Address
First Line	:	6230 HANNON CT
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92117
Country	:	US
Telephone Number	:	760-942-7221
Fax Number	:	760-942-3097

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2010
Last Update Date	:	06/12/2018

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