Individual
DR. JOHN D WALTHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2025 SOQUEL AVE, SANTA CRUZ, CA 95062-1323
(831) 458-5537
Mailing address
PO BOX 276950, SACRAMENTO, CA 95827-6950
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G40705
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609816958
—
CA
01
—
G40705
ANTHEM BLUE CROSS
CA
Enumeration date
06/07/2006
Last updated
12/03/2024
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