Individual provider Active NPI

Richard L. Walter, M.D.

  • Internal Medicine Physician
  • Tarzana, CA
National Provider Identifier
1699731489
Registry record updated Mar 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G31570 Issued in CA
Practice address
5525 Etiwanda Ave
Suite 318
Tarzana, CA 91356-3647
Phone
(818) 528-1270
Fax
(818) 528-1275
NPI assigned
Apr 21, 2006
Last updated
Mar 4, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G31570 CA Primary

Addresses

Primary practice location

5525 Etiwanda Ave
Suite 318
Tarzana, CA 91356-3647

Mailing address

18375 Ventura Blvd
Suite 614
Tarzana, CA 91356-4218
Phone (818) 908-8048

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060404000503 CA Practitioner - Internal Medicine 5890703771

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
31570CAMDClinical Psychologist
G31570CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michael S. Malamed, M.D., a Medical Corporation Internal Medicine Current Accepting new patients
Kamyar Kamjoo MD a Medical Corporation Current Accepting new patients
Richard L. Walter, M.D., a Medical Corporation Internal Medicine CurrentSince Mar 27, 2006 Accepting new patients
Valley Internal Medicine & Nephrology Medical Group Current Accepting new patients

Locations

18375 Ventura Blvd
Tarzana, CA 91356
Phone (818) 422-5322

5525 Etiwanda Ave
Ste 318
Tarzana, CA 91356
Phone (818) 528-1270

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267660800000",
    "number": "1699731489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18375 VENTURA BLVD",
            "address_2": "SUITE 614",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913564218",
            "telephone_number": "818-908-8048",
            "fax_number": "818-908-8072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 ETIWANDA AVE",
            "address_2": "SUITE 318",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563647",
            "telephone_number": "818-528-1270",
            "fax_number": "818-528-1275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTER",
        "first_name": "RICHARD",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-21",
        "last_updated": "2010-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G31570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

Verify at the official NPI Registry.