Provider Demographics
NPI:1174724785
Name:OCALAP'LAPIT, WALTER (PA-C)
Entity type:Individual
Prefix:
First Name:WALTER
Middle Name:
Last Name:OCALAP'LAPIT
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 NORTH ARTHUR CIRCLE
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-1180
Mailing Address - Country:US
Mailing Address - Phone:951-278-4997
Mailing Address - Fax:951-736-7941
Practice Address - Street 1:3 CORPORATE PLAZA DR
Practice Address - Street 2:SUITE 140
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7980
Practice Address - Country:US
Practice Address - Phone:949-642-7757
Practice Address - Fax:949-642-5091
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA12O81363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPA12081BMedicare ID - Type Unspecified