MEDICARE: DR. ANITA A WALTON 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	207R00000X	Internal Medicine Physician	G57217	CA

General Provider Information

NPI Number	:	1639150139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANITA A WALTON MD

Provider Business Mailing Address
First Line	:	6973 LINDA VISTA RD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-6342
Country	:	US
Telephone Number	:	858-279-9676
Fax Number	:	858-279-0377

Provider Business Practice Location Address
First Line	:	6973 LINDA VISTA RD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-6342
Country	:	US
Telephone Number	:	858-279-9676
Fax Number	:	858-279-0377

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

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	12/08/2021

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