Provider Demographics
NPI:1336034016
Name:WALTER S. YOURCHEK, M.D., INC.
Entity type:Organization
Organization Name:WALTER S. YOURCHEK, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:S
Authorized Official - Last Name:YOURCHEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-992-1717
Mailing Address - Street 1:1606 MEADOW AVE
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-1647
Mailing Address - Country:US
Mailing Address - Phone:209-992-1717
Mailing Address - Fax:
Practice Address - Street 1:4637 QUAIL LAKES DR
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-5258
Practice Address - Country:US
Practice Address - Phone:209-992-1717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty