Organization Active NPI

Daniel J. Wall M.D., Inc

  • Dermatology Physician
  • Walnut Creek, CA
National Provider Identifier
1790927655
Registry record updated Mar 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DANIEL J. WALL M.D., INC
Practice address
110 La Casa Via
Suite 205
Walnut Creek, CA 94598-3088
Phone
(925) 952-9003
NPI assigned
Mar 24, 2009
Last updated
Mar 24, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2009

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

Authorized official

Name
Daniel Wall, M.D.
Title
Owner/Physician
Phone
(925) 952-9003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

110 La Casa Via
Suite 205
Walnut Creek, CA 94598-3088

Mailing address

110 La Casa Via
Suite 205
Walnut Creek, CA 94598-3088

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1237852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237852800000",
    "number": "1790927655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 LA CASA VIA",
            "address_2": "SUITE 205",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LA CASA VIA",
            "address_2": "SUITE 205",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983088",
            "telephone_number": "925-952-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL J. WALL M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-24",
        "last_updated": "2009-03-24",
        "status": "A",
        "authorized_official_last_name": "WALL",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "925-952-9003",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2009; 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.