SAMUEL J. WALTERS (NPI# 1790869782) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790869782 |
| Entity Type | Individual |
| Full Name | SAMUEL J. WALTERS |
| Credential | MD |
| Practice Address |
99 Montecillo Rd San Rafael CA 94903-3308 |
| Mailing Address |
1800 Harrison St Fl 7 Oakland CA 94612-3429 |
| Practice Telephone | 4154442000 |
| Mailing Telephone | 5106256262 |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083X0100X |
Preventive Medicine Specialization: Occupational Medicine |
G68055 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G680550 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144368606 | Samuel Roy Walters | Specialist | 401 S Van Brunt St Ste 403, Englewood, NJ 07631-4635 | 2007-02-04 |
| 1336119817 | Samuel Walters | Family Medicine | 6531 103rd St, Jacksonville, FL 32210-7131 | 2006-01-25 |
| Street Address |
99 MONTECILLO RD |
| City | SAN RAFAEL |
| State | CA |
| Zip Code | 94903-3308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174528889 | Jeffry D Cardneau | Surgery | 99 Montecillo Rd, Mob 1, 2nd Floor, Department of Surgery, San Rafael, CA 94903-3308 | 2005-06-17 |
| 1225645468 | Lauren Freudman | Occupational Therapist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2020-09-30 |
| 1285254037 | Omar Ahmed | Pharmacist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2020-04-22 |
| 1447887229 | Meka Angela Parks | Registered Nurse | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2020-03-24 |
| 1710519202 | Mahsa Khorramdin | Pharmacist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2020-02-12 |
| 1568001071 | Jessica Tan | Pharmacist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-12-31 |
| 1720626211 | Ava May Mahan | Pharmacist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-12-15 |
| 1437797271 | Alicia Pontecorvo | Dietitian, Registered | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-12-11 |
| 1437795499 | Shirley Liu | Pharmacist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-11-25 |
| 1831740422 | Natalie Marie Vano | Nurse Practitioner | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467089524 | Christopher Sazo | Counselor | 1 St. Vincents Drive, San Rafael, CA 94903 | 2020-03-26 |
| 1134769482 | Katherine Sieger | Music Therapist | 400 Civic Center Dr. #300, San Rafael, CA 94903 | 2020-01-14 |
| 1679064836 | California In Home Care & Registry, Inc | In Home Supportive Care | 14b Mitchell Blvd, Suite B, San Rafael, CA 94903 | 2018-05-23 |
| 1922557586 | Helen Elizabeth Shamis | Marriage & Family Therapist | 30 North San Pedro, Suite #265, Beyond Hunger, San Rafael, CA 94903 | 2016-09-23 |
| 1033572771 | Henry Colbert | Counselor | 1 St. St. Vincent Drive, San Rafael, CA 94903 | 2016-03-31 |
| 1659736924 | Robyn Bloom | Marriage & Family Therapist | 4 Joseph Court, San Rafael, CA 94903 | 2015-12-30 |
| 1851760565 | Cheryl Clementson | Substance Abuse Rehabilitation Facility | 301 Smith Ranch Road, San Rafael, CA 94903 | 2015-09-23 |
| 1588043731 | Chelsea Cooney | Counselor | 1 St. Vincent's Drive, San Rafael, CA 94903 | 2015-05-20 |
| 1083002315 | Kaiser Permanente | Psychiatric Unit | 111 Smith Ranch Road, Kaiser Permanente, San Rafael, CA 94903 | 2015-01-09 |
| 1366857856 | Travel Well Corporation | Preventive Medicine | 28 Mitchell Blvd, San Rafael, CA 94903 | 2014-06-24 |
| Find all providers in zip 94903 | ||||
| Taxonomy Code | 2083X0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Occupational Medicine |
| Occupational medicine focuses on the health of workers, including the ability to perform work; the physical, chemical, biological, and social environments of the workplace; and the health outcomes of environmental exposures. Practitioners in this field address the promotion of health in the work place, and the prevention and management of occupational and environmental injury, illness, and disability. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447300256 | Wendy E. Shearn | Preventive Medicine | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2007-01-12 |
| 1093893570 | Tim A. Ledean | Preventive Medicine | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2006-11-01 |
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|---|---|---|---|---|
| 1023616240 | Universal Point Clinics Corporation | Preventive Medicine | 1236 Brooks St, Ontario, CA 91762-3608 | 2020-10-09 |
| 1952919763 | John G. Alevizos, D.o., A Professional Medical Corporation | Preventive Medicine | 1530 East Edinger Avenue, Suite 1, Santa Ana, CA 92705 | 2020-07-17 |
| 1790332260 | Aftim A Saba | Preventive Medicine | 1675 7th St Rm 232, Oakland, CA 94615-0002 | 2019-08-20 |
| 1619520905 | Lauren Krumholz Edwards | Preventive Medicine | 3421 Empresa Dr Ste D, San Luis Obispo, CA 93401-7364 | 2019-07-16 |
| 1184285827 | Gurmu Occmed Services Inc | Preventive Medicine | 500 Greenfield Ave, Hanford, CA 93230-3515 | 2019-06-24 |
| 1831605625 | Med Fit Consulting, Inc. | Preventive Medicine | 10425 Tierrasanta Blvd Ste 108, San Diego, CA 92124-2618 | 2017-12-16 |
| 1619482239 | American Health Enterprises, Inc. | Preventive Medicine | 9500 Stockdale Hwy Ste 101, Bakersfield, CA 93311-3621 | 2017-12-05 |
| 1295249548 | Rose Donna Maria Baytop | Preventive Medicine | 2200 Pacific Hwy # Mzq-4, San Diego, CA 92101-1745 | 2017-11-24 |
| 1699295790 | U.S. Healthworks Medical Group, P.C. | Preventive Medicine | 2550 N Hollywood Way Ste 100, Burbank, CA 91505-5015 | 2017-06-21 |
| 1427588706 | Metro Healthcare Medical Corporation | Preventive Medicine | 3440 Wilshire Blvd Ste 1207, Los Angeles, CA 90010-2127 | 2017-06-19 |
| Find all providers with the same taxonomy | ||||
| City | SAN RAFAEL |
| Zip Code | 94903 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.