Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 15422 | CA |
Y | 111NI0013X | Independent Medical Examiner | 15422 | CA |
N | 111NN1001X | Nutrition | 15422 | CA |
N | 111NR0400X | Rehabilitation Chiropractor | 15422 | CA |
N | 111NT0100X | Thermography | 15422 | CA |
N | 111NX0100X | Occupational Health | 15422 | CA |
NPI | 1750693610 |
---|---|
Provider Name | Dr. Patrick Joseph Walter |
First Address | Alameda, CA 94501-1104 |
Second Address | Oakland, CA 94601-1506 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2010 |
Last Update Date | 23/11/2021 |