Provider Demographics
NPI:1164550687
Name:WALKER, KARA ODOM (MD, MPH, MSHS)
Entity Type:Individual
Prefix:DR
First Name:KARA
Middle Name:ODOM
Last Name:WALKER
Suffix:
Gender:F
Credentials:MD, MPH, MSHS
Other - Prefix:DR
Other - First Name:KARA
Other - Middle Name:LYNN
Other - Last Name:ODOM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:2130 HARRISON ST APT 7
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-1393
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:911 BROXTON AVE FL 3
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-2801
Practice Address - Country:US
Practice Address - Phone:310-794-2268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA93624207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA101170Medicare UPIN