MEDICARE: MR. CHARLES WADSWORTH WALKER JR. BS PHARM, RPH

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	183500000X	Pharmacist	RPH36998	CA

General Provider Information

NPI Number	:	1831061761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHARLES WADSWORTH WALKER JR. BS PHARM, RPH

Provider Business Mailing Address
First Line	:	3620 FAIRWAY BLVD
Second Line	:
City	:	VIEW PARK
State	:	CA
Zip	:	90043-1111
Country	:	US
Telephone Number	:	310-962-8268
Fax Number	:

Provider Business Practice Location Address
First Line	:	3620 FAIRWAY BLVD
Second Line	:
City	:	VIEW PARK
State	:	CA
Zip	:	90043-1111
Country	:	US
Telephone Number	:	310-962-8268
Fax Number	:

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

Provider Enumeration Date	:	09/20/2025
Last Update Date	:	09/20/2025

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