Healthcare Provider Details

I. General information

NPI: 1528981537
Provider Name (Legal Business Name): NORMAN WALL DO INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2005 COURT ST STE N
REDDING CA
96001-1807
US

IV. Provider business mailing address

2005 COURT ST STE N
REDDING CA
96001-1807
US

V. Phone/Fax

Practice location:
  • Phone: 707-888-6155
  • Fax: 307-770-7484
Mailing address:
  • Phone: 707-888-6155
  • Fax: 307-770-7484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NORMAN MAYNARD WALL
Title or Position: OWNER
Credential: DO
Phone: 707-888-6165