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General NPI Number Information
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NPI Number | 1417224510
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Entity Type | Individual
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Provider Name | WALTER VALDES PHARMD
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Gender | Male
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Dates
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Enumeration Date | 11/18/2011
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Last Update Date | 11/18/2011
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Provider Practice Location Address
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Address Line | 5600 WHITTIER BLVD T-0189
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City | COMMERCE
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State | CA
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Zip | 90022-4106
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Country | US
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Telephone | 323-725-7861
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Fax |
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Provider Business Mailing Address
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Address Line | 525 LOS ANGELES AVE
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City | MONROVIA
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State | CA
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Zip | 91016-4228
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Country | US
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Telephone | 626-533-9974
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 65922
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License Number State | CA
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