Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 104647 | CA |
NPI | 1073129631 |
---|---|
Provider Name | Dr. Erin Walker |
First Address | Oak Park, CA 91377-3841 |
Second Address | Westlake Village, CA 91361-3024 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2020 |
Last Update Date | 18/09/2020 |