Provider Demographics
NPI:1649210725
Name:WALKER, LORENZO GILES (MD)
Entity Type:Individual
Prefix:
First Name:LORENZO
Middle Name:GILES
Last Name:WALKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 SOLAR DR
Mailing Address - Street 2:#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:805-485-7664
Practice Address - Street 1:2001 SOLAR DR
Practice Address - Street 2:#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:805-485-7664
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG62014207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB99059Medicare UPIN
CAG62014Medicare PIN