Healthcare Provider Details

I. General information

NPI: 1093329096
Provider Name (Legal Business Name): CHAD WALKER AU.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2020
Last Update Date: 01/16/2021
Certification Date: 01/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20911 EARL ST STE 400
TORRANCE CA
90503-4355
US

IV. Provider business mailing address

20911 EARL ST STE 400
TORRANCE CA
90503-4355
US

V. Phone/Fax

Practice location:
  • Phone: 310-370-0007
  • Fax:
Mailing address:
  • Phone: 714-743-2976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number3452
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number3542
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: