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1992162242
KEN CARLSON WALLS
RIVERSIDE, CA
NPI
1992162242
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207R00000X Internal Medicine
(Licence: CA PTL1723)
Additional Taxonomies
363A00000X Physician Assistant
Enumeration Date
2016-01-18
Last Update Date
2023-09-26
Business Address
Dr. KEN CARLSON WALLS PhD, MPAS, DO
10800 MAGNOLIA AVE
RIVERSIDE, CA 92505-3043
Phone number: 951-353-2000
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Mailing Address
Dr. KEN CARLSON WALLS PhD, MPAS, DO
12143 DEWAR DR
RIVERSIDE, CA 92505-4106
Phone number: 314-488-5943
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