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General NPI Number Information
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NPI Number | 1336034016
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Entity Type | Organization
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Legal Business Name | WALTER S YOURCHEK M D INC
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Dates
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Enumeration Date | 06/11/2025
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 4637 QUAIL LAKES DR
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City | STOCKTON
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State | CA
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Zip | 95207-5258
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Country | US
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Telephone | 209-475-8855
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Fax | 209-235-7210
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Provider Business Mailing Address
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Address Line | 1606 MEADOW AVE
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City | STOCKTON
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State | CA
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Zip | 95207-1647
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Country | US
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Telephone | 209-992-1717
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. WALTER S YOURCHEK
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Credential | M.D.
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Telephone | 209-992-1717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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