Madolor King, RN

Primary specialty

Enterostomal Therapy Registered NurseTaxonomy code 163WE0900X

License

2005454883 Issued in CA

Practice address

18002 Irvine Blvd Ste 208
Tustin, CA 92780-3366

Phone

(626) 589-1349

NPI assigned

Jun 24, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Athome Healthcare

  • Home Health Registered Nurse
  • Tustin, CA
  • NPI 1952927055
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1013533116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12501 CIRCULA PANORAMA",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927051356",
            "telephone_number": "626-589-1349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18002 IRVINE BLVD STE 208",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803366",
            "telephone_number": "626-589-1349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "MADOLOR",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-24",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0900X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Enterostomal Therapy",
            "state": "CA",
            "license": "2005454883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryon Kim, LAC
• Sung-Woong Kim, M.D.
• Sunnam Kim, L.AC.
• Susie Kim, MD
• Taehyang Kim, LA.C
• Vijaykumar Ramchandra Kini, MD
• Kinship Center
• Kinship Health at Home Inc
• Angela Irving Kirkman, LCSW
• Andrew S. Kiss, DDS, MD

• Registered Nurse in Tustin, CA
• Providers in Tustin, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.