Provider Demographics
NPI:1073598892
Name:MORGAN, WALTER A (MD)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:A
Last Name:MORGAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4860 Y ST
Mailing Address - Street 2:ACC 1600
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2307
Mailing Address - Country:US
Mailing Address - Phone:916-734-3630
Mailing Address - Fax:916-734-5550
Practice Address - Street 1:4860 Y ST
Practice Address - Street 2:ACC 1600
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2307
Practice Address - Country:US
Practice Address - Phone:916-734-3630
Practice Address - Fax:916-734-5550
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-14
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAGFE7412207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA57876Medicare UPIN