| Doctor Name: | DR. WALTER PRESTON MAYNARD |
| NPI Number: | 1003838301 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | C33935 |
| Business Practice Address: | 125 N Prairie Ave Inglewood, CA - 903011904 |
| Business Phone Number: | 3106719754 |
| Business Fax Number: | 3106713916 |
| Mailing Address: | 125 N Prairie Ave, INGLEWOOD |
| State: | CA |
| Postal Code: | 903011904 |
| Phone Number: | 3106719754 |
| Fax Number: | 3106713916 |
| NPI Enumeration Date: | 07/24/2006 |
| NPI Last Update Date: | 12/18/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | C33935 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |