Individual
MR. JONATHAN MATTHEW KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RADT I
Contact information
Practice address
1904 RICHLAND AVE, CERES, CA 95307-4562
(209) 525-7411
Mailing address
1904 RICHLAND AVE, CERES, CA 95307-4562
(209) 525-7411
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
R1317650818
CA
Other
Enumeration date
09/19/2018
Last updated
09/19/2018
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