Provider Demographics
NPI:1982757563
Name:WALKO, EILEEN G (MD)
Entity type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:G
Last Name:WALKO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5580 CALLE REAL
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93111-1646
Mailing Address - Country:US
Mailing Address - Phone:805-617-7878
Mailing Address - Fax:805-617-7880
Practice Address - Street 1:5580 CALLE REAL
Practice Address - Street 2:
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93111-1646
Practice Address - Country:US
Practice Address - Phone:805-617-7878
Practice Address - Fax:805-617-7880
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-18331208000000X
CAG65830208000000X
HIMD-9327208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000205187OtherHMSA BILLING NUMBER
HI077241-02Medicaid
HIF54433Medicare UPIN