Wallach, Stacey J.

Wallach, Stacey J. is an individual health care provider with primary practice located at 4860 Y St Ob/Gyn, Suite 2500, Acc, Sacramento CA 95817-2307. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery. Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery is her primary health care specialty. Wallach, Stacey J. can be contacted via phone (916) 734-6930.

Contact Information

Primary practice address
4860 Y St Ob/Gyn, Suite 2500, Acc Sacramento CA 95817-2307
Phone: (916) 734-6930
Fax: (916) 734-6666
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X G68624 California
Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery 207VF0040X A68624 California

Profile Details

NPI number 1891779369
LBN Legal business name Wallach, Stacey J.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2005
Last updated Dec 6th, 2016 - about 9 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 1891779369 NPPES
California MEDICAID 00A686240

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