Individual
DR. WALTER SAM MAZEN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1665 ESPLANADE, CHICO, CA 95926-3312
(530) 895-0423
(530) 895-1872
Mailing address
1665 ESPLANADE, CHICO, CA 95926-3312
(530) 895-0423
(530) 895-1872
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
G45960
CA
207VX0000X
Obstetrics Physician
Primary
G45960
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G45960
CALIFORNIA STATE LICENSE
CA
05
—
GROO43570
—
CA
Enumeration date
07/25/2006
Last updated
03/07/2023
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