Provider Demographics
NPI:1942290564
Name:KING, JENNIFER KUEN-LING (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:KUEN-LING
Last Name:KING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 VETERAN AVE
Mailing Address - Street 2:REHAB CENTER 32-59
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-0001
Mailing Address - Country:US
Mailing Address - Phone:310-825-7992
Mailing Address - Fax:310-206-8606
Practice Address - Street 1:1000 VETERAN AVE
Practice Address - Street 2:REHAB CENTER 32-59
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-0001
Practice Address - Country:US
Practice Address - Phone:310-825-7992
Practice Address - Fax:310-206-8606
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA226134207R00000X
CAA95364207RR0500X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A953640Medicaid
CA00A953640Medicaid