Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Walt Jay Medical Corporation

Organization General Practice Physician · NPI 1124164579

Walt Jay Medical Corporation is a General Practice Physician in Los Angeles, California. Licensed in California. Registered with an NPI since 2007.

Licensed in
CA
In the registry since
2007

Practice location Address checks out

1930 Wilshire Blvd Ste 600
Los Angeles, CA 90057-3605
Phone: (213) 483-9902
Fax: (213) 483-5174
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X · Licence A366519 (CA)

Record details

NPI number1124164579
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Sherine Ganegoda — Office Manager'S Assistant · (213) 483-9902
Other names Integrative Industrial And Family Practice Medical Clinics
NPI enumeratedJanuary 30, 2007
Last updated in NPPESAugust 22, 2020
Mailing address1010 Summitridge Dr, Diamond Bar, CA 91765-4364

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