MEDICARE: WALTER RECINOS

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	171M00000X	Case Manager/Care Coordinator
2	172V00000X	Community Health Worker		CA

General Provider Information

NPI Number	:	1669863957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WALTER RECINOS

Provider Business Mailing Address
First Line	:	1360 MISSION ST FL 2
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94103-2647
Country	:	US
Telephone Number	:	415-215-8971
Fax Number	:	628-217-7705

Provider Business Practice Location Address
First Line	:	1360 MISSION ST FL 2
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94103-2647
Country	:	US
Telephone Number	:	415-215-8971
Fax Number	:	628-217-7705

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

Provider Enumeration Date	:	02/09/2015
Last Update Date	:	12/28/2022

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Directions to “ WALTER RECINOS ” Practice Location

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