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Individual

JOHN WALTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
975 S FAIRMONT AVE, LODI, CA 95240-5118
(209) 334-3411
Mailing address
2315 STOCKTON BLVD, SACRAMENTO, CA 95817-2201
(916) 734-7950

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
155925
CA

Other

Enumeration date
04/05/2016
Last updated
10/11/2019
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