Walter E Brackelmanns MD Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

G6575 Issued in CA

Legal business name

WALTER E BRACKELMANNS MD INC

Practice address

14419 Riverside Dr
Sherman Oaks, CA 91423-1713

Phone

(818) 990-1225

Fax

(818) 990-7070

NPI assigned

Jun 17, 2008

Last updated

Jun 17, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Walter E Brackelmanns, MD

Title

President

Phone

(818) 990-1225

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1538320114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14419 RIVERSIDE DR",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914231713",
            "telephone_number": "818-990-1225",
            "fax_number": "818-990-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14419 RIVERSIDE DR",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914231713",
            "telephone_number": "818-990-1225",
            "fax_number": "818-990-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTER E BRACKELMANNS MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-17",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "BRACKELMANNS",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-990-1225",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "G6575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Walgreens Specialty Pharmacy #15293)
• Nancy Walker Rosado, MFT
• Kincaid Walker
• Natalie A Walker
• Catherine Jessica Wallace
• Patricia Sue Walter, MFT, BC-ATR
• James Edgar Walton, PH.D.
• Johannah Grace Walton, PHD
• Lial Waneis
• David Wang, MD

• Community/Behavioral Health Agency in Sherman Oaks, CA
• Providers in Sherman Oaks, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.