Wallace, David Alan
Wallace, David Alan is an individual health care provider with primary practice located at 11600 Wilshire Blvd Ste 200, Los Angeles CA 90025-1782. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Wallace, David Alan can be contacted via phone (310) 828-2020.Contact Information
Primary practice address
11600 Wilshire Blvd Ste 200
Los Angeles CA 90025-1782
Phone: (310) 828-2020
Fax: (310) 914-3009
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | G37076 | California |
Profile Details
| NPI number | 1679576276 |
|---|---|
| LBN Legal business name | Wallace, David Alan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 27th, 2005 |
| Last updated | Apr 6th, 2010 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679576276 | NPPES |
| California | Other | G37076 | CA MEDICAL LICENSE |
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