Provider Demographics
NPI:1992950067
Name:J WALKER CHIROPRACTIC
Entity type:Organization
Organization Name:J WALKER CHIROPRACTIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/PART OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:AMBER
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:760-967-7444
Mailing Address - Street 1:1012 S COAST HWY
Mailing Address - Street 2:SUITE G
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-5058
Mailing Address - Country:US
Mailing Address - Phone:760-967-7444
Mailing Address - Fax:760-967-7445
Practice Address - Street 1:1012 S COAST HWY
Practice Address - Street 2:SUITE G
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-5058
Practice Address - Country:US
Practice Address - Phone:760-967-7444
Practice Address - Fax:760-967-7445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-17
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 30518111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1992950067OtherMEDICARE NPI
CA1992950067OtherMEDICARE NPI
CA6480810001Medicare NSC