Walt Jay Medical Corporation
NPI 1124164579 · General Practice Physician · Los Angeles, CA
Walt Jay Medical Corporation is a General Practice Physician organization in Los Angeles, CA (NPI 1124164579).
Provider details
- NPI number
- 1124164579
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Sherine Ganegoda, Office Manager'S Assistant(213) 483-9902
- License
- A366519 (CA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Integrative Industrial and Family Practice Medical Clinics
Registry dates
- Enumerated
- 2007-01-30
- Last updated
- 2020-08-22
Frequently asked questions
- What is Walt Jay Medical Corporation's NPI number?
- Walt Jay Medical Corporation's National Provider Identifier (NPI) is 1124164579, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Walt Jay Medical Corporation?
- Walt Jay Medical Corporation is classified in the NPPES registry as General Practice Physician (Allopathic & Osteopathic Physicians).
- Where is Walt Jay Medical Corporation located?
- Walt Jay Medical Corporation's practice location on file with NPPES is 1930 Wilshire Blvd, Los Angeles, CA 90057-3605.
- What is Walt Jay Medical Corporation's phone number?
- The practice phone number listed in the NPPES registry for Walt Jay Medical Corporation is (213) 483-9902.
- Who is the authorized official for Walt Jay Medical Corporation?
- The authorized official listed on Walt Jay Medical Corporation's NPPES record is Sherine Ganegoda, Office Manager'S Assistant. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Walt Jay Medical Corporation's NPI active?
- Yes — Walt Jay Medical Corporation's NPI (1124164579) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.