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1356973432
BRENT STEVEN WALLER
ANAHEIM, CA
NPI
1356973432
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CA 95013038)
Enumeration Date
2020-02-06
Last Update Date
2020-02-07
Business Address
BRENT STEVEN WALLER FNP-BC
3400 W BALL RD STE 207
ANAHEIM, CA 92804-3737
Phone number: 714-683-5100
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Mailing Address
BRENT STEVEN WALLER FNP-BC
766 S LANGTREE LN
ANAHEIM, CA 92807-4897
Phone number:
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