Provider Demographics
NPI:1467435636
Name:WALKER, WENDELL CHEVELL
Entity Type:Individual
Prefix:MS
First Name:WENDELL
Middle Name:CHEVELL
Last Name:WALKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 W 99TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90003-3919
Mailing Address - Country:US
Mailing Address - Phone:323-678-1055
Mailing Address - Fax:
Practice Address - Street 1:414 W 99TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90003-3919
Practice Address - Country:US
Practice Address - Phone:323-678-1055
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging