Basic Information
Provider Information
NPI: 1295269264
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WALTON
FirstName: NICOLAS
MiddleName: ASHER
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1400 E CHURCH ST
Address2: C/O HOSPITALIST OFFICE
City: SANTA MARIA
State: CA
PostalCode: 934545906
CountryCode: US
TelephoneNumber: 8057393000
FaxNumber:  
Practice Location
Address1: 1400 E CHURCH ST
Address2: HOSPITALIST OFFICE
City: SANTA MARIA
State: CA
PostalCode: 934545906
CountryCode: US
TelephoneNumber: 8057393000
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/17/2017
LastUpdateDate: 08/31/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000X20A16928CAN Allopathic & Osteopathic PhysiciansHospitalist 
207Q00000X20A16928CAY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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