Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 30401 | TX |
Y | 1223P0700X | Prosthodontist | 101731 | CA |
NPI | 1235533605 |
---|---|
Provider Name | Dr. Wei King |
First Address | Torrance, CA 90503-8909 |
Second Address | Torrance, CA 90505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2014 |
Last Update Date | 12/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101731 | DENTAL BOARD OF CALIFORNIA (01) | CA |
30401 | TEXAS STATE BOARD OF DENTAL EXAMINERS (01) | TX |