Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | A63330 | CA |
N | 207PE0004X | Emergency Medical Services | A63330 | CA |
N | 207PP0204X | Pediatric Emergency Physician | A6330 | CA |
NPI | 1578529947 |
---|---|
Provider Name | Paul F. Walsh |
First Address | Sacramento, CA 95817-1460 |
Second Address | Sacramento, CA 95817-1460 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2006 |
Last Update Date | 19/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A633300 | (05) | CA |
H84675 | (02) | CA |