Organization
WALT JAY MEDICAL CORPORATION
Active
Organization
WALT JAY MEDICAL CORPORATION
Active
Other names
Integrative Industrial and Family Practice Medical Clinics
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHERINE GANEGODA (OFFICE MANAGER'S ASSISTANT)
(213) 483-9902
Entity
Organization
Contact information
Practice address
1701 W WHITTIER BLVD, MONTEBELLO, CA 90640-4004
(323) 887-3577
(323) 887-9567
Mailing address
PO BOX 39152, DOWNEY, CA 90239-0152
(310) 724-0597
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
DC16212
CA
Other
Enumeration date
01/24/2007
Last updated
08/22/2020
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