KEN CARLSON WALLS

RIVERSIDE, CA
NPI1992162242
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207R00000X Internal Medicine
(Licence: CA  PTL1723)
Additional Taxonomies363A00000X Physician Assistant
Enumeration Date2016-01-18
Last Update Date2023-09-26
Business Address
Dr. KEN CARLSON WALLS PhD, MPAS, DO
10800 MAGNOLIA AVE
RIVERSIDE, CA 92505-3043
Phone number: 951-353-2000
Mailing Address
Dr. KEN CARLSON WALLS PhD, MPAS, DO
12143 DEWAR DR
RIVERSIDE, CA 92505-4106
Phone number: 314-488-5943