MEDICARE: BRIAN 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	208600000X	Surgery Physician	G43347	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306834957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN WALKER MD

Provider Business Mailing Address
First Line	:	13847 E 14TH ST
Second Line	:	SUITE 118
City	:	SAN LEANDRO
State	:	CA
Zip	:	94578-2632
Country	:	US
Telephone Number	:	510-352-8400
Fax Number	:

Provider Business Practice Location Address
First Line	:	13847 E 14TH ST
Second Line	:	SUITE 118
City	:	SAN LEANDRO
State	:	CA
Zip	:	94578-2632
Country	:	US
Telephone Number	:	510-352-8400
Fax Number	:

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

Provider Enumeration Date	:	10/07/2005
Last Update Date	:	07/08/2007

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Directions to “ BRIAN WALKER MD” Practice Location

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