Provider Demographics
NPI:1649205394
Name:KING, WESLEY A (MD)
Entity Type:Individual
Prefix:DR
First Name:WESLEY
Middle Name:A
Last Name:KING
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Gender:M
Credentials:MD
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Mailing Address - Street 1:450 N ROXBURY DR
Mailing Address - Street 2:FLOOR 3
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4231
Mailing Address - Country:US
Mailing Address - Phone:310-385-1918
Mailing Address - Fax:310-385-9007
Practice Address - Street 1:450 N ROXBURY DR
Practice Address - Street 2:FLOOR 3
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4231
Practice Address - Country:US
Practice Address - Phone:310-385-1918
Practice Address - Fax:310-385-9007
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2015-04-21
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Provider Licenses
StateLicense IDTaxonomies
CAA42379207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA42379CMedicare PIN