Provider Demographics
NPI:1093867970
Name:WALKER, ROBERT C (DO)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:C
Last Name:WALKER
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Gender:M
Credentials:DO
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Mailing Address - Street 1:2315 OTAY LAKES ROAD
Mailing Address - Street 2:SUITE 306
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91914
Mailing Address - Country:US
Mailing Address - Phone:714-389-5700
Mailing Address - Fax:714-389-6973
Practice Address - Street 1:2315 OTAY LAKES ROAD
Practice Address - Street 2:SUITE 306
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914
Practice Address - Country:US
Practice Address - Phone:714-389-5700
Practice Address - Fax:714-389-6973
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2011-05-16
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Provider Licenses
StateLicense IDTaxonomies
CA20A8425207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G34104Medicare UPIN