Provider Demographics
NPI:1437374402
Name:WALKER, REGINALD ORRIN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:REGINALD
Middle Name:ORRIN
Last Name:WALKER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11496 BRIDGEWAY DR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-3465
Mailing Address - Country:US
Mailing Address - Phone:951-688-1870
Mailing Address - Fax:
Practice Address - Street 1:1422 E FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90001-1937
Practice Address - Country:US
Practice Address - Phone:323-582-6363
Practice Address - Fax:323-582-0955
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43539183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist