Individual
KATHLEEN M. WALTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1401 S GRAND AVE, EMERGENCY DEPARTMENT, LOS ANGELES, CA 90015-3010
(213) 748-2411
Mailing address
2100 POWELL ST, SUITE 900, EMERYVILLE, CA 94608-1826
(510) 350-2660
(510) 879-9100
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2)A7331
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX73310
—
CA
Enumeration date
05/16/2006
Last updated
11/16/2007
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