Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | A149220 | CA |
NPI | 1295053437 |
---|---|
Provider Name | Ashley Walther |
First Address | Los Angeles, CA 90027-6062 |
Second Address | Los Angeles, CA 90027 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2010 |
Last Update Date | 25/06/2019 |