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NPI Code Detail

MEDICARE: DR. WALTER YIM O.D.

MEDICARE: DR. WALTER YIM O.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
1152W00000XOptometrist12675TCA

General Provider Information

NPI Number : 1962531228
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WALTER YIM O.D.
Provider Business Mailing Address
First Line : 1873 W FALMOUTH AVE
Second Line :
City : ANAHEIM
State : CA
Zip : 92801-7715
Country : US
Telephone Number : 714-588-1366
Fax Number :
Provider Business Practice Location Address
First Line : 10088 ADAMS AVE
Second Line :
City : HUNTINGTON BEACH
State : CA
Zip : 92646-4905
Country : US
Telephone Number : 714-962-9377
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2007
Last Update Date : 07/08/2007

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