DR. WALTER PRESTON MAYNARD M.D. NPI 1003838301

NPI Information

NPI: 1003838301
Provider Name: DR. WALTER PRESTON MAYNARD, M.D.
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

PECOS Registration: Yes

Address:
125 N PRAIRIE AVE
INGLEWOOD, CA
ZIP 90301
Phone: (310) 671-9754
Get Directions

DR. Walter Preston Maynard, M.D. is a diagnostic radiology radiology in Inglewood, CA. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. DR. Walter Preston Maynard, M.D. NPI is 1003838301. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

125 N PRAIRIE AVE
INGLEWOOD, CA
ZIP 90301-904
Phone: (310) 671-9754
Fax: (310) 671-3916

The NPI 1003838301 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/24/2006 and was last updated on 3/7/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085B0100X	Radiology	Body Imaging	C33935	CALIFORNIA	No
2	2085N0700X	Radiology	Neuroradiology	C33935	CALIFORNIA	No
3	2085N0904X	Radiology	Nuclear Radiology	C33935	CALIFORNIA	No
4	2085P0229X	Radiology	Pediatric Radiology	C33935	CALIFORNIA	No
5	2085R0202X	Radiology	Diagnostic Radiology	C33935	CALIFORNIA	Yes
6	2085R0203X	Radiology	Therapeutic Radiology	C33935	CALIFORNIA	No
7	2085R0204X	Radiology	Vascular & Interventional Radiology	C33935	CALIFORNIA	No
8	2085U0001X	Radiology	Diagnostic Ultrasound	C33935	CALIFORNIA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00C339353	OTHER	CALIFORNIA	NHIC-MEDICARE-CMS
2	C33935	OTHER	CALIFORNIA	PHYSICIAN & SURGEON
3	00C339350	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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