Individual
DR. CAROL NICOLE DE WALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3330 LOMITA BLVD, TORRANCE, CA 90505-5002
(310) 270-7477
Mailing address
2390 CRENSHAW BLVD UNIT 708, TORRANCE, CA 90501-3300
(310) 270-7747
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A95208
CA
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
A95208
CA
Other
Enumeration date
03/11/2009
Last updated
01/23/2024
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