MEDICARE: LAWRENCE R. WALKER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	C42773	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	20024497	OTHER	CA	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1083619910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAWRENCE R. WALKER MD

Provider Business Mailing Address
First Line	:	1901 W LUGONIA AVE
Second Line	:	SUITE 230
City	:	REDLANDS
State	:	CA
Zip	:	92374-9703
Country	:	US
Telephone Number	:	909-557-1600
Fax Number	:	909-557-1732

Provider Business Practice Location Address
First Line	:	29099 HOSPITAL ROAD
Second Line	:	SUITE 114
City	:	LAKE ARROWHEAD
State	:	CA
Zip	:	92352
Country	:	US
Telephone Number	:	909-726-6100
Fax Number	:	909-557-1745

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	07/05/2012

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