Individual
WALTER THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
12044 BRADDOCK DR, CULVER CITY, CA 90230-5811
(310) 398-6408
Mailing address
12044 BRADDOCK DR, CULVER CITY, CA 90230-5811
(310) 398-6408
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA15198
CA
Other
Enumeration date
09/06/2007
Last updated
09/06/2007
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