Provider Demographics
NPI:1417075490
Name:LORENZO G. WALKER, M.D., A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:LORENZO G. WALKER, M.D., A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LORENZO
Authorized Official - Middle Name:G
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-485-7764
Mailing Address - Street 1:2001 SOLAR DR
Mailing Address - Street 2:SUITE 275
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-2645
Mailing Address - Country:US
Mailing Address - Phone:805-485-7764
Mailing Address - Fax:805-604-4763
Practice Address - Street 1:2001 SOLAR DR
Practice Address - Street 2:SUITE 275
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2645
Practice Address - Country:US
Practice Address - Phone:805-485-7764
Practice Address - Fax:805-604-4763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG62014207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DQ9184OtherRAIL ROAD
DQ9184OtherRAIL ROAD