Provider Demographics
NPI:1528086964
Name:WALKER, DONNA (MD)
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 E OCEAN AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-7047
Mailing Address - Country:US
Mailing Address - Phone:805-735-1155
Mailing Address - Fax:805-735-1133
Practice Address - Street 1:1201 E OCEAN AVE STE B
Practice Address - Street 2:
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-7082
Practice Address - Country:US
Practice Address - Phone:805-735-1155
Practice Address - Fax:805-735-1133
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA55693207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A556930Medicaid
CADE654ZMedicare PIN