Provider Demographics
NPI:1295936441
Name:KING, TINA M (NP)
Entity type:Individual
Prefix:MS
First Name:TINA
Middle Name:M
Last Name:KING
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:1001 POTRERO AVE # 1E21
Mailing Address - Street 2:SFGH EMERGENCY MEDICINE
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3518
Mailing Address - Country:US
Mailing Address - Phone:415-206-8111
Mailing Address - Fax:415-924-2001
Practice Address - Street 1:1001 POTRERO AVE # 1E21
Practice Address - Street 2:SFGH EMERGENCY MEDICINE
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:415-206-8111
Practice Address - Fax:415-924-2001
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CARN390920163WE0003X
CANPF6596363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WE0003XNursing Service ProvidersRegistered NurseEmergency
Not Answered363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
033654OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER
033654OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER