Wallace, Paul Wesley
Wallace, Paul Wesley is an individual health care provider with primary practice located at 8920 Wilshire Blvd Suite 327, Beverly Hills CA 90211-2007. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Wallace, Paul Wesley can be contacted 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: (310) 652-8499
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | A049918 | California |
Profile Details
| NPI number | 1063494474 |
|---|---|
| LBN Legal business name | Wallace, Paul Wesley |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 19th, 2005 |
| Last updated | Oct 16th, 2007 - about 17 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 | 1063494474 | NPPES |
| California | MEDICAID | 00A499180 |
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