Marc Randal Walters, R.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

960209 Issued in CA

Practice address

1415 Ross Ave
El Centro, CA 92243-4306

Phone

(760) 339-7179

NPI assigned

Jul 19, 2006

Last updated

Apr 27, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524787200000",
    "number": "1760401863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 ROSS AVE",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922434306",
            "telephone_number": "760-339-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 ROSS AVE",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922434306",
            "telephone_number": "760-339-7179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "MARC",
        "middle_name": "RANDAL",
        "name_prefix": "Mr.",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2018-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "960209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Walgreens #06856)
• Krystal Danielle Walker, PMHNP
• Nichole Walla
• Walmart Inc. (Walmart Pharmacy 10-1555)
• Walmart Stores, Inc. (Vision Center 30-1555)
• Bonnie Walther
• Erick Omar Wancho
• Leila Wang, PHARMD, RPH
• Evelyn Ward
• Lupe Lee Waters

• Registered Dietitian in El Centro, CA
• Providers in El Centro, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2018; 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.