Provider Demographics
NPI:1376517292
Name:WALKER, BRUCE J (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:J
Last Name:WALKER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 2430
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93457-2430
Mailing Address - Country:US
Mailing Address - Phone:267-828-4902
Mailing Address - Fax:844-351-5566
Practice Address - Street 1:1145 E CLARK AVE STE I
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-5171
Practice Address - Country:US
Practice Address - Phone:805-364-4412
Practice Address - Fax:805-324-6217
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA626522083P0500X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH42820Medicare UPIN