Provider Demographics
NPI:1588907836
Name:WALTHER, AKO M (MD)
Entity type:Individual
Prefix:DR
First Name:AKO
Middle Name:M
Last Name:WALTHER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2333 MOWRY AVE 300
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1626
Mailing Address - Country:US
Mailing Address - Phone:510-796-0222
Mailing Address - Fax:510-796-7760
Practice Address - Street 1:10 WOODLAND RD
Practice Address - Street 2:
Practice Address - City:SAINT HELENA
Practice Address - State:CA
Practice Address - Zip Code:94574-9554
Practice Address - Country:US
Practice Address - Phone:707-963-6399
Practice Address - Fax:707-967-5915
Is Sole Proprietor?:No
Enumeration Date:2013-04-04
Last Update Date:2017-10-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA124467207R00000X, 208D00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA2344773Medicare PIN