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:
Health care specialties
| Specialty | Code | License # | 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 14 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 | 1164467320 | NPPES |
| California | MEDICAID | 00G456900 |
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