Provider Demographics
NPI:1366508244
Name:TONI GAYLE WALKER
Entity Type:Organization
Organization Name:TONI GAYLE WALKER
Other - Org Name:SOUTH FIGUEROA DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:TONI
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:323-298-7543
Mailing Address - Street 1:PO BOX 2942
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90305-0942
Mailing Address - Country:US
Mailing Address - Phone:323-298-7543
Mailing Address - Fax:323-298-7952
Practice Address - Street 1:1503 W MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90062-1743
Practice Address - Country:US
Practice Address - Phone:323-298-7543
Practice Address - Fax:323-298-7952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY405523336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0520886OtherNCPDP PROVIDER IDENTIFICATION NUMBER