Active NPI
King Anthony Sparks, PHLEBOTOMY TECHNICIA
- Contractor
- Wilmington, CA
National Provider Identifier
1508093907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- CPT3277799
- Practice address
- 1254 N Wilmington Blvd
Wilmington, CA 90744-2402 - Phone
- (213) 926-7970
- NPI assigned
- Jun 12, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | CPT3277799 | CA | Primary |
Addresses
Primary practice location
1254 N Wilmington Blvd
Wilmington, CA 90744-2402
Mailing address
PO Box 60526
Los Angeles, CA 90060-0526
Phone (213) 926-7970
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CPT3277799 | CA | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245369600000",
"number": "1508093907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 60526",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900600526",
"telephone_number": "213-926-7970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1254 N WILMINGTON BLVD",
"city": "WILMINGTON",
"state": "CA",
"postal_code": "907442402",
"telephone_number": "213-926-7970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPARKS",
"first_name": "KING",
"middle_name": "ANTHONY",
"name_prefix": "Mr.",
"credential": "PHLEBOTOMY TECHNICIA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-06-12",
"last_updated": "2009-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "CA",
"license": "CPT3277799",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.