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| Type | Person | [sources] | |||
|---|---|---|---|---|---|
| Name | Aubrey Ancil King | [sources] | |||
| Other name | King, Sr., Aubrey | [sources] | |||
| Birth date | not available | [sources] | |||
| Nationality | not available | [sources] | |||
| Country | United States | [sources] | |||
| First name | Aubrey | [sources] | |||
| Last name | King | [sources] | |||
| Middle name | Ancil | [sources] | |||
| NPI | 1316125081 · 1669577896 | [sources] | |||
| Registration number | 00G560230 · 00G560231 · 00G560232 · G 56023 | [sources] | |||
| Sector | Physician | [sources] | |||
| Address | 13840 Darwin Drive, Moreno Valley, CA, 92555 | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers suspended from or otherwise deemed ineligible to participate in California's Medicaid program.
United States · DHCS
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