Walters, Mark
Walters, Mark is an individual health care provider with primary practice located at 747 52Nd Street , Oakland CA 94609. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology, which is considered as his primary health care specialty. Walters, Mark can be contacted via phone (510) 428-3374.Contact Information
Primary practice address
747 52Nd Street
Oakland CA 94609
Phone: (510) 428-3374
Fax: (510) 601-3916
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology | 2080P0207X | G85406 | California |
Profile Details
| NPI number | 1588753610 |
|---|---|
| LBN Legal business name | Walters, Mark |
| Credentials | MO |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 12th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588753610 | NPPES |
| California | MEDICAID | 00G854060 |
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