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Individual

DR. DONALD WALTON WALLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
24451 HEALTH CENTER DR, LAGUNA HILLS, CA 92653-3689
(949) 837-4500
(949) 837-4621
Mailing address
PO BOX 10429, NEWPORT BEACH, CA 92658-0429
(949) 417-1812
(949) 417-1803

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G24834
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00G248340
BLUE SHIELD ID #
CA
05
00G248340
CA
01
00G248340385
CALOPTIMA ID #
CA
Enumeration date
09/16/2006
Last updated
07/09/2007
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