Organization · Type 2 NPI

Walt Jay Medical Corporation

General Practice Physician · Los Angeles, CA

NPI number 1124164579 Active

Practice location

1930 Wilshire Blvd, Suite 600
Los Angeles, CA 90057-3605

Call (213) 483-9902 Map

Fax (213) 483-5174

Mailing address

1010 Summitridge Dr
Diamond Bar, CA 91765-4364

Specialties and licenses

Taxonomy	Code	License
General Practice Physician Primary	208D00000X	A366519 (CA)

General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

18 other providers at this address

Other general practice physician providers in Los Angeles

See all in Los Angeles →

NPI record

NPI: 1124164579
Entity type: Organization (Type 2)
Issued: Jan 30, 2007
Last updated: Aug 22, 2020
Status: Active

Other names

<unavail>
Integrative Industrial and Family Practice Medical Clinics · doing business as

Authorized official

Mrs. Sherine Ganegoda
Office Manager's Assistant
(213) 483-9902

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1124164579

Walt Jay Medical Corporation's National Provider Identifier is 1124164579, issued on Jan 30, 2007. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Los Angeles, CA. The record was last updated on Aug 22, 2020.