Provider Demographics
NPI:1245482645
Name:DAVID H.C. KING, M.D., A MEDICAL CORPORATION
Entity type:Organization
Organization Name:DAVID H.C. KING, M.D., A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:HC
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-866-2500
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA70154208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00A701540Medicare PIN