Provider Demographics
NPI:1548472491
Name:WALKER, WILBUR GORDON JR (MD)
Entity type:Individual
Prefix:
First Name:WILBUR
Middle Name:GORDON
Last Name:WALKER
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:2505 SAMARITAN DRIVE
Mailing Address - Street 2:SUITE 501
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124
Mailing Address - Country:US
Mailing Address - Phone:408-358-3663
Mailing Address - Fax:408-356-3939
Practice Address - Street 1:2505 SAMARITAN DRIVE
Practice Address - Street 2:SUITE 501
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124
Practice Address - Country:US
Practice Address - Phone:408-358-3663
Practice Address - Fax:408-356-3939
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2008-07-16
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Provider Licenses
StateLicense IDTaxonomies
CAC418742084P0800X
CAAW322549332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No332900000XSuppliersNon-Pharmacy Dispensing Site