Wallace, David

Wallace, David is an individual health care provider with primary practice located at 18350 Roscoe Blvd # 702 , Northridge CA 91325-4109. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Wallace, David can be contacted via phone (818) 280-5961.

Contact Information

Primary practice address
18350 Roscoe Blvd # 702 Northridge CA 91325-4109
Phone: (818) 280-5961
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA59863 California

Profile Details

NPI number 1730852179
LBN Legal business name Wallace, David
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 30th, 2021
Last updated Jul 30th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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