Wallace, John George

Wallace, John George is an individual health care provider with primary practice located at 4101 Torrance Blvd Em Dept, Torrance CA 90503-4607. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medical Services, which is considered as his primary health care specialty. Wallace, John George can be contacted via phone (310) 540-7676.

Contact Information

Primary practice address
4101 Torrance Blvd Em Dept Torrance CA 90503-4607
Phone: (310) 540-7676
Fax: (405) 751-3183
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X G45690 California

Profile Details

NPI number 1164467320
LBN Legal business name Wallace, John George
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 19th, 2006
Last updated Sep 19th, 2012 - about 12 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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Identifiers

StateTypeNumberIssuer
All States NPI 1164467320 NPPES
California MEDICAID 00G456900

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