Healthcare Provider Details

I. General information

NPI: 1548316219
Provider Name (Legal Business Name): WALTER W STRAUSER, MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 12/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2999 HEALTH CENTER DR
SAN DIEGO CA
92123-2762
US

IV. Provider business mailing address

2999 HEALTH CENTER DR
SAN DIEGO CA
92123-2762
US

V. Phone/Fax

Practice location:
  • Phone: 858-939-4489
  • Fax: 858-939-4487
Mailing address:
  • Phone: 858-939-4489
  • Fax: 858-939-4487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License NumberG56903
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberG56903
License Number StateCA

VIII. Authorized Official

Name: DR. WALTER WILLIAM STRAUSER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 858-939-4489