Mr Austin Tanaka Waller, is a
Case Manager/care Coordinator based in San Diego, California. Mr Austin Tanaka Waller is licensed to practice in * (Not Available) (license number ) and his current practice location is
995 Gateway Center Way Ste 300, San Diego, California. He can be reached at his office (for appointments etc.) via phone at
(619) 398-2168.
NPI number for Mr Austin Tanaka Waller is 1508350851 and his current mailing address is 995 Gateway Center Way Ste 300, San Diego, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1508350851.
Healthcare Provider's Profile
| Full Name | Mr Austin Tanaka Waller |
|---|
| Gender | Male |
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| Speciality | Case Manager/care Coordinator |
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| Location | 995 Gateway Center Way Ste 300, San Diego, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1508350851
- Provider Enumeration Date: 06/20/2018
- Last Update Date: 09/26/2023
Medical Identifiers
Medical identifiers for Mr Austin Tanaka Waller such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1508350851 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 103K00000X | Behavior Analyst | F5130372 (California) | Secondary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Austin Tanaka Waller is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Austin Tanaka Waller,
995 Gateway Center Way Ste 300,
San Diego, CA 92102-4550
Ph: (193) 982-1566 | Mr Austin Tanaka Waller,
995 Gateway Center Way Ste 300,
San Diego, CA 92102-4550
Ph: (619) 398-2168 |
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