Healthcare Provider Details

I. General information

NPI: 1508363987
Provider Name (Legal Business Name): AMELIA WALKER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2018
Last Update Date: 06/08/2024
Certification Date: 06/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38350 40TH ST E
PALMDALE CA
93552-3075
US

IV. Provider business mailing address

38350 40TH ST E STE 100
PALMDALE CA
93552-3075
US

V. Phone/Fax

Practice location:
  • Phone: 661-225-3030
  • Fax:
Mailing address:
  • Phone: 661-225-3030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA165304
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: