Individual
MR. MARC RANDAL WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.D.
Contact information
Practice address
1415 ROSS AVE, EL CENTRO, CA 92243-4306
(760) 339-7179
Mailing address
1415 ROSS AVE, EL CENTRO, CA 92243-4306
(760) 339-7100
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
960209
CA
Other
Enumeration date
07/19/2006
Last updated
04/27/2018
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