Individual
GARY BLAINE WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
421 E MERCED AVE, WEST COVINA, CA 91790-5023
(626) 918-1881
(626) 918-3618
Mailing address
280 TEAGUE DR, SAN DIMAS, CA 91773-3376
(909) 394-6160
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA14463
CA
Other
Enumeration date
12/13/2006
Last updated
03/03/2010
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