MEDICARE: DR. STEPHANIE ANNE WALTON M.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
1	208000000X	Pediatrics Physician	G070902	CA

General Provider Information

NPI Number	:	1558313312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHANIE ANNE WALTON M.D.

Provider Business Mailing Address
First Line	:	7237 E SOUTHGATE DR
Second Line	:	SUITE A
City	:	SACRAMENTO
State	:	CA
Zip	:	95823-2637
Country	:	US
Telephone Number	:	916-422-6635
Fax Number	:	916-422-6500

Provider Business Practice Location Address
First Line	:	7237 E SOUTHGATE DR
Second Line	:	SUITE A
City	:	SACRAMENTO
State	:	CA
Zip	:	95823-2637
Country	:	US
Telephone Number	:	916-422-6635
Fax Number	:	916-422-6500

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

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	02/07/2012

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