Provider Demographics
NPI:1730292251
Name:WALKER, DANIEL A (PT, DPT, OCS)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:A
Last Name:WALKER
Suffix:
Gender:M
Credentials:PT, DPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3033 5TH AVE
Mailing Address - Street 2:SUITE 410
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-5856
Mailing Address - Country:US
Mailing Address - Phone:619-228-9668
Mailing Address - Fax:619-228-9685
Practice Address - Street 1:3033 5TH AVE
Practice Address - Street 2:SUITE 410
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-5856
Practice Address - Country:US
Practice Address - Phone:619-228-9668
Practice Address - Fax:619-228-9685
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 34200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPENDINGMedicare PIN