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General NPI Number Information
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NPI Number | 1952574816
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Entity Type | Organization
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Legal Business Name | WALTER W WATSON MD A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 04/10/2008
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Last Update Date | 04/29/2020
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Provider Practice Location Address
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Address Line | 555 E HARDY ST
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City | INGLEWOOD
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State | CA
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Zip | 90301-4011
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Country | US
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Telephone | 310-673-4660
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Fax |
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Provider Business Mailing Address
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Address Line | 3465 TORRANCE BLVD
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City | TORRANCE
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State | CA
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Zip | 90503-5804
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Country | US
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Telephone | 310-792-3914
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Fax | 310-792-3802
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. WALTER WILLIAM WATSON
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Credential | M.D.
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | C41555
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License Number State | CA
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