Healthcare Provider Details

I. General information

NPI: 1154687259
Provider Name (Legal Business Name): SARA ELIZABETH WALZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2012
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 BOWER DR
MEDFORD OR
97501-3688
US

IV. Provider business mailing address

PO BOX 31001-4180
PASADENA CA
91110-0001
US

V. Phone/Fax

Practice location:
  • Phone: 541-732-8300
  • Fax:
Mailing address:
  • Phone: 541-732-8300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD176738
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: