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General NPI Number Information
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NPI Number | 1811976640
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Entity Type | Individual
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Provider Name | CHRISTOPHER SCOTT WALTHOUR MD
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Gender | Male
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Dates
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Enumeration Date | 01/11/2006
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Last Update Date | 12/15/2015
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Provider Practice Location Address
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Address Line | 441 W EATON AVE
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City | TRACY
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State | CA
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Zip | 95376-3420
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Country | US
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Telephone | 209-830-4062
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Fax |
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Provider Business Mailing Address
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Address Line | 600 COFFEE RD
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City | MODESTO
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State | CA
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Zip | 95355-4201
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Country | US
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Telephone | 209-521-6097
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | C52856
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License Number State | CA
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