Healthcare Provider Details

I. General information

NPI: 1689659187
Provider Name (Legal Business Name): LOUISE CHRISTIE WALTER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/07/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 CLEMENT ST VA MEDICAL CENTER 181G
SAN FRANCISCO CA
94121-1545
US

IV. Provider business mailing address

4150 CLEMENT ST VA MEDICAL CENTER 181G
SAN FRANCISCO CA
94121-1545
US

V. Phone/Fax

Practice location:
  • Phone: 415-221-4810
  • Fax: 415-750-6641
Mailing address:
  • Phone: 415-221-4810
  • Fax: 415-750-6641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberA061028
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: