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Search › California › 164X00000X

Virgil Waller

NPI 1346889318 · on the registry since 2019

Practice

Address
10429 International Blvd
Oakland, CA 94603
Phone
(510) 777-8448
Organisation at this address
Lifeline Treatment Services Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
29

Registry record

Primary taxonomy
164X00000X
164X00000X
Also registered as
106S00000X
Licence states on file
CA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2022-08-04

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California