Healthcare Provider Details

I. General information

NPI: 1871565416
Provider Name (Legal Business Name): DAVID L. WALTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 03/12/2020
Certification Date: 03/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 VALLEY CHILDRENS PL # FE16
MADERA CA
93636-8761
US

IV. Provider business mailing address

275 W MACARTHUR
OAKLAND CA
94611-5641
US

V. Phone/Fax

Practice location:
  • Phone: 559-353-6700
  • Fax: 559-353-6710
Mailing address:
  • Phone: 510-752-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberG74318
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: