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Individual

MRS. MADOLOR KING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
18002 IRVINE BLVD STE 208, TUSTIN, CA 92780-3366
(626) 589-1349
Mailing address
12501 CIRCULA PANORAMA, SANTA ANA, CA 92705-1356
(626) 589-1349

Taxonomy

Speciality
Code
Description
License number
State
163WE0900X
Enterostomal Therapy Registered Nurse
Primary
2005454883
CA

Other

Enumeration date
06/24/2020
Last updated
06/24/2020
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