Individual
DR. RONALD RAYMOND WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16250 MAIN STREET, SUITE A, LOWER LAKE, CA 95457-0713
(707) 995-3011
(707) 995-3019
Mailing address
PO BOX 713, LOWER LAKE, CA 95457-0713
(707) 995-3011
(707) 995-3019
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
G51470
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G514700
BLUE SHIELD NUMBER
CA
05
—
00G514700
—
CA
Enumeration date
09/20/2006
Last updated
07/09/2007
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