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NPI Code Detail

MEDICARE: MICHAEL THOMAS WALKER PH.D.

MEDICARE: MICHAEL THOMAS WALKER PH.D.
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
1103TC0700XClinical PsychologistPSY 13954CA

General Provider Information

NPI Number : 1427134915
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL THOMAS WALKER PH.D.
Provider Business Mailing Address
First Line : 3751 STOCKER ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90008-5101
Country : US
Telephone Number : 323-298-3687
Fax Number :
Provider Business Practice Location Address
First Line : 3751 STOCKER ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90008-5101
Country : US
Telephone Number : 323-298-3687
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2006
Last Update Date : 07/08/2007

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