Walter K Theis MD a Medical Corporation

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

G29942 Issued in CA

Legal business name

WALTER K THEIS MD A MEDICAL CORPORATION

Practice address

3011 Wilshire Blvd
Santa Monica, CA 90403-2301

Phone

(310) 264-8385

Fax

(310) 264-9076

NPI assigned

Mar 4, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Walter Kurt Theis II, M.DNPI 1174733398

Title

President

Phone

(310) 264-8385

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Walter Kurt Theis II, M.D.

  • Trauma Surgery Physician
  • Santa Monica, CA
  • NPI 1174733398
  Authorized official Same address or phone

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

{
    "created_epoch": "1267660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267660800000",
    "number": "1649593690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15322 ANTIOCH ST",
            "address_2": "#87",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902723603",
            "telephone_number": "310-264-8385",
            "fax_number": "310-264-9076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 WILSHIRE BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904032301",
            "telephone_number": "310-264-8385",
            "fax_number": "310-264-9076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTER K THEIS MD A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-04",
        "last_updated": "2010-03-04",
        "status": "A",
        "authorized_official_last_name": "THEIS",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "KURT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-264-8385",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "G29942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William L Wallace, PHD
• Mark S Wallen, DPM
• David Wallenstein
• Wendy Walsdorf, LMFT
• Therese Anne Walsh, L.AC., PH.D.
• Anique Walters, DPT
• Darrell Walters, PHD
• Kenneth Brian Waltzer, M.D.
• Chelsea Wan, L.AC.
• Canty Wang

• Physical Therapy Clinic/Center in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Physical Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2010; 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.