Wallace, Thomas M
Wallace, Thomas M is an individual health care provider with primary practice located at 1441 Florida Ave , Modesto CA 95350-4405. He recently has only one registered license in Allopathic & Osteopathic Physicians / Critical Care Medicine, which is considered as his primary health care specialty. Wallace, Thomas M can be contacted via phone (209) 576-3525.Contact Information
Primary practice address
1441 Florida Ave
Modesto CA 95350-4405
Phone: (209) 576-3525
Fax: (209) 576-3544
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | G42269 | California |
Profile Details
NPI number | 1679641666 |
---|---|
LBN Legal business name | Wallace, Thomas M |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Nov 30th, 2006 |
Last updated | Jul 8th, 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.
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