Wallace Medical Group, Inc

LBN: Wallace Medical Group, Inc
Wallace Medical Group, Inc is an health care organization with primary practice located at 8920 Wilshire Blvd Suite 327, Beverly Hills CA 90211-2007. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Procedural Dermatology, which is considered as the primary health care specialty. Wallace Medical Group, Inc can be contacted via phone (310) 652-8460, or through Wallace, Paul Wesley via phone (310) 652-8460.

Contact Information

Primary practice address
8920 Wilshire Blvd Suite 327 Beverly Hills CA 90211-2007
Phone: (310) 652-8460
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Wallace, Paul Wesley Doctor of Medicine (MD)
Phone: (310) 652-8460

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Procedural Dermatology 207NS0135X A49918 California

Profile Details

NPI number 1104047596
LBN Legal business name Wallace Medical Group, Inc
DBA Doing business as
Authorized official Wallace, Paul Wesley Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 1st, 2007
Last updated Oct 16th, 2007 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104047596 NPPES
California MEDICAID GR0062020

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