Active NPI
Mark Paul Walberg, PHARM.D., M.A.
- Pharmacist
- Stockton, CA
National Provider Identifier
1679769467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 58756
- Practice address
- 10437 Henshaw Dr
Stockton, CA 95219-7153 - Phone
- (805) 338-5546
- NPI assigned
- Sep 14, 2007
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 58756 | CA | Primary |
Addresses
Primary practice location
10437 Henshaw Dr
Stockton, CA 95219-7153
Mailing address
10437 Henshaw Dr
Stockton, CA 95219-7153
Phone (805) 338-5546
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)
- Not enrolled
- Credentials
- Master of Arts, Doctor of Pharmacy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189728000000",
"number": "1679769467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10437 HENSHAW DR",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952197153",
"telephone_number": "805-338-5546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10437 HENSHAW DR",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952197153",
"telephone_number": "805-338-5546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALBERG",
"first_name": "MARK",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "PHARM.D., M.A.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-09-14",
"last_updated": "2007-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "58756",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.