Organization
WALT JAY MEDICAL CORPORATION
Active
Other names
Integrative Industrial and Family Practice Medical Clinics
Organization subpart
No
Provider details
NPI number
Authorized official
SHERINE GANEGODA (OFFICE MANAGER'S ASSISTANT)
(213) 483-9902
Entity
Organization
Contact information
Practice address
1930 WILSHIRE BLVD, SUITE 505, LOS ANGELES, CA 90057-3605
(213) 483-9902
Mailing address
2011 PRAY ST, FULLERTON, CA 92833-5070
(661) 803-0468
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
G00078400
CA
Other
Enumeration date
02/06/2007
Last updated
08/22/2020
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