Provider Demographics
NPI:1578507083
Name:KING, DAVID HC (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:HC
Last Name:KING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 DARDANELLI LN
Mailing Address - Street 2:SUITE 23B
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-1440
Mailing Address - Country:US
Mailing Address - Phone:408-866-2500
Mailing Address - Fax:408-866-2469
Practice Address - Street 1:320 DARDANELLI LN
Practice Address - Street 2:SUITE 23B
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1440
Practice Address - Country:US
Practice Address - Phone:408-866-2500
Practice Address - Fax:408-866-2469
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA70154208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A-701540Medicare ID - Type Unspecified
CAF44844Medicare UPIN