Healthcare Provider Details

I. General information

NPI: 1457488439
Provider Name (Legal Business Name): KATHLEEN WALKER MAYER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 CALIFORNIA AVE FL 2
BAKERSFIELD CA
93309-7024
US

IV. Provider business mailing address

109 S STATE ST STE 5
CHICAGO IL
60603-5606
US

V. Phone/Fax

Practice location:
  • Phone: 617-505-1520
  • Fax: 617-928-8401
Mailing address:
  • Phone: 617-505-1520
  • Fax: 617-928-8401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number37902
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC176095
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: