SearchNevada363A00000X

Christopher Waller, IDC

NPI 1871850321 · on the registry since 2012 · sole proprietor

Practice

Address
4755 Pasture Rd Bldg 299
Fallon, NV 89496
Phone
(775) 426-3125
Fax
(775) 426-3135
Organisation at this address
U.S. Navy
Nhc Lemoore
Inferred from a shared address, not stated in the registry.
Clinicians at this address
18

Additional practice sites

  • 34800 Bob Wilson Dr, San Diego, CA
  • 10180 Bausell Pl, San Diego, CA

Registry record

Primary taxonomy
363A00000X
363A00000X
Also registered as
1710I1002X
Licence states on file
CA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2024-03-12

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 Nevada