Provider Demographics
NPI:1376033142
Name:UROLOGY WELLNESS CENTRE
Entity Type:Organization
Organization Name:UROLOGY WELLNESS CENTRE
Other - Org Name:CENTER FOR MEN'S HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:J
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-846-4177
Mailing Address - Street 1:477 N EL CAMINO REAL STE C204
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1332
Mailing Address - Country:US
Mailing Address - Phone:760-230-2256
Mailing Address - Fax:760-452-2665
Practice Address - Street 1:477 N EL CAMINO REAL STE C204
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1332
Practice Address - Country:US
Practice Address - Phone:760-230-2256
Practice Address - Fax:760-452-2665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-16
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty