Active NPI
Brian Walker, MD
- Surgery Physician
- San Leandro, CA
National Provider Identifier
1306834957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- G43347
- Practice address
- 13847 E 14TH St
Suite 118
San Leandro, CA 94578-2632 - Phone
- (510) 352-8400
- NPI assigned
- Oct 7, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | G43347 | CA | Primary |
Addresses
Primary practice location
13847 E 14TH St
Suite 118
San Leandro, CA 94578-2632
Mailing address
13847 E 14TH St
Suite 118
San Leandro, CA 94578-2632
Phone (510) 352-8400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4405629 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306834957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13847 E 14TH ST",
"address_2": "SUITE 118",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945782632",
"telephone_number": "510-352-8400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13847 E 14TH ST",
"address_2": "SUITE 118",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945782632",
"telephone_number": "510-352-8400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "BRIAN",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "G43347",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4405629",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Leandro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.