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NPI Code Detail

MEDICARE: DR. MIGNON WALKER MD

MEDICARE: DR. MIGNON 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
1208D00000XGeneral Practice PhysicianA77862CA

General Provider Information

NPI Number : 1780836114
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MIGNON WALKER MD
Provider Business Mailing Address
First Line : 2447 PACIFIC COAST HWY FL 2
Second Line :
City : HERMOSA BEACH
State : CA
Zip : 90254-2743
Country : US
Telephone Number : 310-941-1513
Fax Number : 888-611-0861
Provider Business Practice Location Address
First Line : 2447 PACIFIC COAST HWY FL 2
Second Line :
City : HERMOSA BEACH
State : CA
Zip : 90254-2743
Country : US
Telephone Number : 310-941-1513
Fax Number : 888-611-0861
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2008
Last Update Date : 08/30/2023

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Directions to “ DR. MIGNON WALKER MD” Practice Location

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