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Tyler King

Student in an Organized Health Care Education/Training Program in Orange, CA. Individual provider (NPI-1).

NPI number1114426558
StatusActive
Last updated in NPPESFeb 11, 2018

Details

NPI
1114426558
Entity type
Individual (NPI-1)
Name
Tyler King
Sex
Male
Sole proprietor
Yes
Enumeration date
Feb 11, 2018
Last updated
Feb 11, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
390200000X Student in an Organized Health Care Education/Training Program––Yes
2255A2300X Specialist/Technologist, Athletic Trainer––

Practice location

281 W Linden Dr
Orange, CA 92865-5010

Phone 805-551-2086

Mailing address

281 W Linden Dr
Orange, CA 92865-5010

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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

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