Healthcare Provider Details

I. General information

NPI: 1669177168
Provider Name (Legal Business Name): JEFFREY WALKER MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7485 MISSION VALLEY RD STE 106
SAN DIEGO CA
92108-4422
US

IV. Provider business mailing address

PO BOX 34120
RENO NV
89533-4120
US

V. Phone/Fax

Practice location:
  • Phone: 619-291-3737
  • Fax: 619-220-8973
Mailing address:
  • Phone: 775-747-5050
  • Fax: 775-747-5050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY B WALKER
Title or Position: MD/OWNER
Credential: MD
Phone: 775-747-5050