Provider Demographics
NPI:1659388338
Name:KING, TALMADGE EVERETT JR (MD)
Entity Type:Individual
Prefix:
First Name:TALMADGE
Middle Name:EVERETT
Last Name:KING
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 0120
Mailing Address - Street 2:505 PARNUSSUS AVENUE
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0120
Mailing Address - Country:US
Mailing Address - Phone:415-476-0909
Mailing Address - Fax:415-502-5869
Practice Address - Street 1:505 PARNASSUS AVE
Practice Address - Street 2:M-994
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-0120
Practice Address - Country:US
Practice Address - Phone:415-476-0909
Practice Address - Fax:415-502-5869
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG84197207RP1001X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G841972Medicaid
CA00G841972Medicaid
CA00G841970Medicaid