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WALSH MEDICAL GROUP A PROFESSIONAL CORPORATION NPI 1407021421


NPI Information

NPI: 1407021421
Provider Name: WALSH MEDICAL GROUP, A PROFESSIONAL CORPORATION
Classification: Point of Service - 305S00000X
Entity Type: Organization

CLIA Number: 05D1054815

Address:
1110 W LA PALMA AVE STE 6
ANAHEIM, CA
ZIP 92801
Phone: (714) 502-1144
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WALSH MEDICAL GROUP, A PROFESSIONAL CORPORATION is a point of service in Anaheim, CA. The provider is this product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. WALSH MEDICAL GROUP, A PROFESSIONAL CORPORATION NPI is 1407021421. The provider is registered as an organization entity type.

The provider's business location address is:

1110 W LA PALMA AVE STE 6
ANAHEIM, CA
ZIP 92801-823
Phone: (714) 502-1144
Fax: (714) 502-1146

The provider's authorized official is Lindsay Martinez .
The authorized official title is Office Manager and has the following contact phone number (714) 502-1144.

The CLIA number assigned to this NPI record is 05D1054815 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/30/2008 and was last updated on 3/26/2020.


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
1305S00000XPoint of Service00A325660CALIFORNIAYes

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
100A325660OTHERCALIFORNIAMEDI-CAL

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: 5/5/2024

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