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General NPI Number Information
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NPI Number | 1114192390
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Entity Type | Organization
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Legal Business Name | WALSH MEDICAL GROUP,A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 04/28/2008
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Last Update Date | 07/20/2022
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Provider Practice Location Address
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Address Line | 947 S ANAHEIM BLVD STE 115
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City | ANAHEIM
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State | CA
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Zip | 92805-5582
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Country | US
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Telephone | 714-533-7320
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Fax | 714-533-7321
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Provider Business Mailing Address
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Address Line | 947 S ANAHEIM BLVD STE 115
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City | ANAHEIM
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State | CA
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Zip | 92805-5582
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Country | US
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Telephone | 714-533-7320
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Fax | 714-533-7321
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LINDSAY MARTINEZ
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Credential |
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Telephone | 714-502-1144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 00A325660
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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