BRENT WALTA

SAN LUIS OBISPO, CA
NPI1922243658
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: CA  G72406)
Enumeration Date2008-12-09
Last Update Date2008-12-09
Business Address
-- BRENT WALTA M.D.
CALIFORNIA MENS COLONY N. HIGHWAY 1
SAN LUIS OBISPO, CA 93409-0001
Phone number: 805-547-7900
Mailing Address
-- BRENT WALTA M.D.
CALIFORNIA MENS COLONY PO BOX 8101, N. HIGHWAY 1
SAN LUIS OBISPO, CA 93409-0001
Phone number: 805-547-7900
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