Provider Demographics
NPI:1336458520
Name:KING, MONIKA (DC)
Entity Type:Individual
Prefix:
First Name:MONIKA
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 IRVINE AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-3127
Mailing Address - Country:US
Mailing Address - Phone:714-357-1759
Mailing Address - Fax:949-688-6806
Practice Address - Street 1:3400 IRVINE AVE STE 109
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-3127
Practice Address - Country:US
Practice Address - Phone:714-357-1759
Practice Address - Fax:949-688-6806
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-05
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28972111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC28972OtherDC LICENSE