Individual
DR. CHARLES M WALWORTH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11190 WARNER AVE, SUITE 411, FOUNTAIN VALLEY, CA 92708-4019
(714) 751-5800
(714) 751-5860
Mailing address
1380 HILLCREST DR, LAGUNA BEACH, CA 92651-1447
(949) 376-5731
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G83332
CA
Other
Enumeration date
01/10/2006
Last updated
07/08/2007
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