King's Pharmacy and Compounding Center

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY50750 Issued in CA

Legal business name

KING'S PHARMACY AND COMPOUNDING CENTER

Doing business as

King's Pharmacy and Compounding Center

Practice address

510 Superior Ave Ste 120
Newport Beach, CA 92663-3665

Phone

(949) 631-4624

Fax

(949) 631-4626

NPI assigned

Oct 6, 2011

Organization subpart

No

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

Authorized official

Name

Ali Rezaei

Title

Pic/Owner

Phone

(949) 244-9415

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• King's Pharmacy and Compounding Center Doing business as

Locations

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

{
    "created_epoch": "1317859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399593600000",
    "number": "1417231630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 SUPERIOR AVE",
            "address_2": "SUITE 120",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633663",
            "telephone_number": "949-631-4624",
            "fax_number": "949-631-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 SUPERIOR AVE STE 120",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633665",
            "telephone_number": "949-631-4624",
            "fax_number": "949-631-4626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING'S PHARMACY AND COMPOUNDING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-06",
        "last_updated": "2014-05-09",
        "status": "A",
        "authorized_official_last_name": "REZAEI",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "PIC/OWNER",
        "authorized_official_telephone_number": "949-244-9415"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY50750",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2132199",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "King's Pharmacy and Compounding Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer J. King, MD
• Joshua Ryan King
• Monika King, D.C.
• Ryan David King, D.P.T.
• Shelby King
• Heather K Kipp, B.A., SLPA
• Steven Kirin, PHYSICAL THERAPY
• Jennifer E Kirk, ACNP
• Lori Kirk
• Emily Kirkbride, MA, LMFT

• Community/Retail Pharmacy in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2014; 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.