| Carl King | |
|
2001 S Barrington Ave Ste 204 Los Angeles CA 90025-5385 | |
| (818) 501-5375 | |
| Not Available |
| Full Name | Carl King |
|---|---|
| Speciality | Psychologist |
| Location | 2001 S Barrington Ave Ste 204, Los Angeles, California |
| Authorized Official Name and Position | Carl King (CLINICAL PSYCOLOGIST) |
| Authorized Official Contact | 8185015375 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carl King 8574 Cole Crest Dr Los Angeles CA 90046-1914 Ph: () - | Carl King 2001 S Barrington Ave Ste 204 Los Angeles CA 90025-5385 Ph: (818) 501-5375 |
| NPI Number | 1164053765 |
|---|---|
| Provider Enumeration Date | 02/01/2020 |
| Last Update Date | 09/01/2021 |
| Certification Date | 09/01/2021 |
| Medicare PECOS PAC ID | 2163833815 |
|---|---|
| Medicare Enrollment ID | O20201201002078 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164053765 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Carl L King |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962628933 PECOS PAC ID: 3072924729 Enrollment ID: I20201201002240 |
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