Individual
JILL WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6555 COYLE AVE, CARMICHAEL, CA 95608-0302
(916) 536-2500
Mailing address
3400 DATA DR, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G66619
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000810564975
PHCS
CA
05
—
00G666190
—
CA
01
—
029615
HEALTH NET
CA
01
—
1232511
UNITED HEALTHCARE
CA
01
—
19708
INTERPLAN
CA
01
—
546782
GREAT WEST
CA
01
—
5914451
AETNA
CA
01
—
7038199
CIGNA
CA
01
—
90073071
PACIFICARE
CA
01
—
94382
FIRST HEALTH
CA
01
—
G66619
BLUE CROSS
CA
01
—
MCMG118100
WESTERN HEALTH ADVANTAGE
CA
Enumeration date
08/31/2006
Last updated
02/13/2012
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