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General NPI Number Information
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NPI Number | 1134380249
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Entity Type | Organization
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Legal Business Name | KIMBERLY R WALTON MD INC
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Dates
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Enumeration Date | 06/20/2008
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Last Update Date | 06/20/2008
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Provider Practice Location Address
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Address Line | 1294 W 6TH ST 201-A
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City | SAN PEDRO
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State | CA
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Zip | 90731-2987
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Country | US
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Telephone | 310-831-6515
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Fax | 310-831-6523
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Provider Business Mailing Address
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Address Line | 1294 W 6TH ST 201-A
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City | SAN PEDRO
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State | CA
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Zip | 90731-2987
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Country | US
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Telephone | 310-831-6515
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Fax | 310-831-6523
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Authorized Official
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Title or Position | PRESIDENT
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Name | KIMBERLY R WALTON
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Credential |
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Telephone | 310-792-3914
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | A80933
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License Number State | CA
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