Provider Demographics
NPI:1376781765
Name:W MAIER INC
Entity Type:Organization
Organization Name:W MAIER INC
Other - Org Name:WALTER M. MAIER M.D.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:MARKUS
Authorized Official - Last Name:MAIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-337-3661
Mailing Address - Street 1:PO BOX 1141
Mailing Address - Street 2:
Mailing Address - City:CEDAR GLEN
Mailing Address - State:CA
Mailing Address - Zip Code:92321-1141
Mailing Address - Country:US
Mailing Address - Phone:909-337-3661
Mailing Address - Fax:909-337-3570
Practice Address - Street 1:29099 HOSPITAL ROAD
Practice Address - Street 2:SUITE 112
Practice Address - City:LAKE ARROWHEAD
Practice Address - State:CA
Practice Address - Zip Code:92352
Practice Address - Country:US
Practice Address - Phone:909-337-3661
Practice Address - Fax:909-337-3570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-23
Last Update Date:2009-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG82114207P00000X, 2083P0901X, 208D00000X
CAG0821142083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental MedicineGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG04002Medicare UPIN
CABG519Medicare PIN