MARK WALTERS MO NPI 1588753610

NPI Information

  • NPI: 1588753610
  • Provider Name: MARK WALTERS, MO
  • Classification: Pediatrics - 2080P0207X
  • Specialization: Pediatric Hematology-Oncology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 747 52ND STREET
    OAKLAND, CA
    ZIP 94609
  • Phone: (510) 428-3374

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NPI Details

Mark Walters, MO is a pediatric hematology-oncology pediatrics in Oakland, CA. The provider is a pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. Mark Walters, MO NPI is 1588753610. 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:

747 52ND STREET
OAKLAND, CA
ZIP 94609
Phone: (510) 428-3374
Fax: (510) 601-3916

The NPI 1588753610 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 10/12/2006 and was last updated on 7/8/2007.

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
12080P0207XPediatricsPediatric Hematology-OncologyG85406CALIFORNIAYes

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
1F16354MEDICARE UPIN
200G854060MEDICARE ID-TYPE UNSPECIFIED
300G854060MEDICAIDCALIFORNIA

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: 3/30/2025

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