Provider Demographics
NPI:1215244488
Name:WALKER, STEVEN D (PHARMACIST)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:D
Last Name:WALKER
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 492
Mailing Address - Street 2:517 RIVIERA DRIVE
Mailing Address - City:LAKE ARROWHEAD
Mailing Address - State:CA
Mailing Address - Zip Code:92352-0492
Mailing Address - Country:US
Mailing Address - Phone:909-337-6918
Mailing Address - Fax:
Practice Address - Street 1:27177 STATE HIGHWAY 189
Practice Address - Street 2:
Practice Address - City:BLUE JAY
Practice Address - State:CA
Practice Address - Zip Code:92317-0017
Practice Address - Country:US
Practice Address - Phone:909-336-1275
Practice Address - Fax:909-337-0791
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 37651183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist